title: Relationship between genotypes of hepatitis C virus and histopathological manifestations in chronic hepatitis C patients.
abstract: OBJECTIVE
  The aim of this study was to assess the relationship between HCV genotype and histological liver injury.
  
  
  METHODS
  Prospective study on a cohort of patients with biopsy proven chronic hepatitis C.
  
  
  METHODS
  University medical centre.
  
  
  METHODS
  Enrolled were 324 consecutive patients (male 197, median age 52 years, range 19-68; chronic hepatitis, 224; cirrhosis, 100).
  
  
  METHODS
  HCV genotype was determined by the INNO LiPA assay and HCV RNA levels by the bDNA assay. The histological features were scored according to the histology activity index.
  
  
  RESULTS
  The distribution of HCV genotypes was 1a, 4.6%; 1b, 52.4%; 2a/c, 27%; 3a, 8%; 4, 2%; mixed, 6%. Serum HCV RNA levels were similar for all genotypes. There was no difference in the distribution of HCV genotypes between patients with chronic hepatitis and those with cirrhosis. Patients with genotype 1b and those with type 2a/c showed a similar prevalence of cases of cirrhosis (33% versus 31%, respectively). In addition, in a subgroup of 102 patients with an established date of infection, the progression to cirrhosis occurred with a similar length of time for HCV type 1b and 2a/c (median 16 versus 15 years, respectively). Patients with HCV genotype 2a/c or mixed genotype showed a higher histology activity index than those with type 1b (P< 0.01), whereas there was no difference in the fibrosis score for the different genotypes. Patients with genotype 3a showed a significantly higher prevalence of steatosis compared to those infected with other genotypes. Alanine aminotransferase (ALT) values were higher in patients with HCV type 2a/c, 3a and mixed genotype than those with type 1 (P < 0.002).
  
  
  CONCLUSIONS
  The data indicate that there is no association between a particular HCV genotype and the progression to cirrhosis, and that specific genotypes are associated with distinct histopathological and biochemical manifestations although none of them is correlated with an increase of the fibrosis stage.
authors.affiliation: Institute of Medical Therapy, Faculty of Medicine, Second University of Naples, Italy.
authors.forename: L E
authors.initials: LE
authors.lastname: Adinolfi
authors.forename: R
authors.initials: R
authors.lastname: Utili
authors.forename: A
authors.initials: A
authors.lastname: Andreana
authors.forename: M F
authors.initials: MF
authors.lastname: Tripodi
authors.forename: P
authors.initials: P
authors.lastname: Rosario
authors.forename: G
authors.initials: G
authors.lastname: Mormone
authors.forename: E
authors.initials: E
authors.lastname: Ragone
authors.forename: G
authors.initials: G
authors.lastname: Pasquale
authors.forename: G
authors.initials: G
authors.lastname: Ruggiero
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000145:classification / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000145:classification / Q000150:complications / Q000473:pathology / Q000821:virology*; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000209:etiology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D012367:RNA, Viral