Liver fibrosis assessment with semiquantitative indexes and image analysis quantification in sustained-responder and non-responder interferon-treated patients with chronic hepatitis C.
OBJECTIVE
The effect of interferon on the reduction of liver fibrosis is controversial. We aimed to compare semiquantitative methods with a quantitative digital image analysis system to assess liver fibrosis in biopsies from patients with chronic hepatitis and different responses to interferon.


METHODS
We studied 98 liver biopsies with chronic hepatitis C before and after recombinant interferon alfa-2 treatment, using conventional histological assessment, grading of histological activity, scoring/staging of fibrosis (Knodell and Scheuer), and quantification of fibrosis with image analysis (FibroQuant).


RESULTS
Sustained-responders to interferon showed a significant reduction in histological lesions and in their Knodell and Scheuer activity indexes. The semiquantitative systems showed no reduction in fibrosis. The FibroQuant application showed a significant reduction in porto-periportal and septal areas among sustained-responders (P < 0.001) and non-responders (P < 0.05), and in porto-periportal and septal fibrosis areas only in sustained-responders (P < 0.001), whereas the percentage of fibrosis increased in non-responders (P < 0.001).


CONCLUSIONS
The Scheuer system is useful for the daily evaluation of fibrosis, but the FibroQuant application provides more objective data on the anti-fibrogenic effects of interferon, which include a reduction in the porto-periportal area in sustained-responders and non-responders, accompanied by a reduction in the area of fibrosis only when the viral replication has ceased.
Caballero
T
T
Department of Pathology, School of Medicine and University Hospital, University of Granada, Spain. trinidad@ugr.es
Pérez-Milena
A
A
Masseroli
M
M
O'Valle
F
F
Salmerón
F J
FJ
Del Moral
R M
RM
Sánchez-Salgado
G
G
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D001706:Biopsy; D005260:Female; D005355:Fibrosis; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000473:pathology*; D006652:Histological Techniques / Q000592:standards; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007370:Interferon Type I / Q000627:therapeutic use*; D008099:Liver / Q000473:pathology*; D008297:Male; D011994:Recombinant Proteins; D016896:Treatment Outcome
D000998:Antiviral Agents; D007370:Interferon Type I; D011994:Recombinant Proteins