Assessment of histological features in chronic hepatitis C.
OBJECTIVE
Hepatitis C virus infection is an important disease with a high chronicity rate (50-80%), leading to end-stage liver cirrhosis and hepatocellular carcinoma. In this study, the characteristic histological findings were compared with the epidemiological features of hepatitis C virus infection in liver biopsy material.


METHODS
Liver biopsies were studied from 106 patients (60 males, 46 females, aged 11-81 years, mean: 43) found positive for hepatitis C antibody by a second-generation ELISA method. The histological evaluation was based upon the Desmet classification of chronic hepatitis. Statistical analysis involved the chi 2 test.


RESULTS
Minimal, mild chronic, and moderate chronic hepatitis were manifest in 13%, 65% and 22% of the cases, while fibrosis 0/1, fibrosis 2, fibrosis 3 and cirrhosis (fibrosis 4) occurred in 42%, 13%, 35% and 10%, respectively. Regarding the histological features of chronic hepatitis C, the frequency of steatosis, lymphoid follicles and/or aggregates and bile duct lesions showed an increase parallel with the hepatitis grade, the changes being more pronounced in moderate chronic hepatitis.


CONCLUSIONS
Most chronic hepatitis C patients displayed mild histological lesions with stage 1 fibrosis. Lymphoid follicles and/or aggregates, bile duct damage and steatosis are important diagnostic features that show strong correlation with chronic hepatitis activity. The occurrence of stage 3/4 fibrosis in mild chronic hepatitis alerts the hepatologists for the need of liver biopsy.
Jármay
Katalin
K
First Department of Internal Medicine, Faculty of Health Sciences, Albert Szent-Györgyi Medical University, Szeged, P.O. Box 469, Hungary, H-6701.
Karácsony
Gizella
G
Ozsvár
Zsófia
Z
Nagy
István
I
Lonovics
János
J
Schaff
Zsuzsa
Z
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications / Q000453:epidemiology* / Q000473:pathology*; D006801:Humans; D015994:Incidence; D008103:Liver Cirrhosis / Q000145:classification* / Q000209:etiology*; D008107:Liver Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index