Clinical, virological, and pathological significance of hepatic bile duct injuries in Chinese patients with chronic hepatitis C.
OBJECTIVE
Hepatic bile duct injuries are characteristic histological findings in patients with chronic hepatitis C virus (HCV) infection. However, the pathogenesis and clinical significance of this phenomenon remain unclear. The aims of this study were to evaluate the prevalence and clinical significance of hepatic bile duct injuries in Chinese patients with chronic hepatitis C.


METHODS
One hundred and seventeen Chinese patients with chronic hepatitis C were enrolled. Clinical, biochemical, immunological (serum autoantibodies and cryoglobulinemia), histological, and virological data (serum HCV RNA titer and HCV genotype) were compared between patients with and without hepatic bile duct injuries.


RESULTS
Eighty-three (71%) of the 117 patients with chronic hepatitis C had hepatic bile duct injuries. Patients with hepatic bile duct injuries had a significantly higher frequency of HCV genotype 1b; a higher mean serum globulin level; significantly higher mean scores for histological periportal necro-inflammation, portal inflammation, and fibrosis; and more severe portal lymphoid aggregation/follicles when compared with patients without hepatic bile duct injuries (P < 0.05, all). No significant differences in the presence of serum autoantibodies, cryoglobulinemia, mean serum HCV RNA titer, or response to interferon treatment were noted between the two groups. Multivariate logistic regression analysis showed that HCV genotype 1b infection, portal inflammation, and lymphoid aggregation/follicles were significant independent predictors associated with hepatic bile duct injuries.


CONCLUSIONS
The presence of hepatic bile duct injuries in Chinese patients with chronic hepatitis C was significantly correlated with HCV genotype 1b infection, and the patients with these injuries had more severe portal inflammation and formation of lymphoid aggregates/follicles.
Hwang
S J
SJ
Department of Family Medicine, Veterans General Hospital-Taipei, Taiwan.
Luo
J C
JC
Chu
C W
CW
Lai
C R
CR
Tsay
S H
SH
Chang
F Y
FY
Lee
S D
SD
D000328:Adult; D000368:Aged; D044466:Asian People; D001323:Autoantibodies / Q000097:blood; D001652:Bile Ducts / Q000293:injuries* / Q000821:virology*; D021121:Branched DNA Signal Amplification Assay; D016001:Confidence Intervals; D003449:Cryoglobulinemia / Q000097:blood / Q000209:etiology; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000097:blood / Q000473:pathology / Q000821:virology; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000473:pathology / Q000821:virology*; D006801:Humans; D008099:Liver / Q000737:chemistry*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D015995:Prevalence; D012313:RNA / Q000097:blood; D012372:ROC Curve; D012720:Severity of Illness Index; D013624:Taiwan / Q000453:epidemiology
D001323:Autoantibodies; D012313:RNA