title: Histological evolution of chronic hepatitis C. Factors related to progression.
abstract: We have evaluated the histological progression of liver disease in 29 untreated patients with chronic hepatitis C. All patients were positive to antibodies to hepatitis C virus by ELISA2 and RIBA2. Two liver biopsies were carried out for each patient, with an interval ranging between 12 and 126 months (mean 50.2 +/- 30.7). In all cases the usual histological classification was applied and the histological activity index scoring system according to Knodell et al. was determined. Fifteen cases worsened (51.7%), 12 cases showed no histological changes (41.4%) and two patients improved (6.9%). Cirrhosis was found in five patients (18.5%) in the second liver biopsy. Epidemiological, clinical, biochemical and histological progression and the group with impairment in liver histology. Factors related to histological worsening were: more advanced age (p = 0.002), high levels of aspartate aminotransferase (p = 0.04), high global histological activity index (p = 0.03) and piecemeal necrosis and bridging necrosis scores (p = 0.02) at first biopsy. The histological activity index can be applied to assess the natural history of chronic viral hepatitis, and is a good tool to evaluate the prognosis. Thus chronic hepatitis C virus infection is a histologically progressive disease in at least half the cases.
authors.affiliation: Department of Gastroenterology, Son Dureta Hospital, Palma de Mallorca, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Vaquer
authors.forename: R
authors.initials: R
authors.lastname: Canet
authors.forename: A
authors.initials: A
authors.lastname: Llompart
authors.forename: J
authors.initials: J
authors.lastname: Riera
authors.forename: A
authors.initials: A
authors.lastname: Obrador
authors.forename: J
authors.initials: J
authors.lastname: Gayá
mesh_terms: D000328:Adult; D001706:Biopsy; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000276:immunology; D006508:Hepatitis Antibodies / Q000032:analysis; D006526:Hepatitis C / Q000453:epidemiology / Q000473:pathology*; D018937:Hepatitis C Antibodies; D006521:Hepatitis, Chronic / Q000453:epidemiology / Q000473:pathology* / Q000821:virology; D006801:Humans; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000473:pathology / Q000821:virology; D008297:Male; D011379:Prognosis; D013997:Time Factors
chemical_list: D006508:Hepatitis Antibodies; D018937:Hepatitis C Antibodies