Prognostic factors for progression of liver structural lesions in chronic hepatitis C patients.
OBJECTIVE
To evaluate the epidemiological, clinical, laboratory and histological variables capable of predicting the progression of hepatic structural disturbances in chronic hepatitis C patients during the time interval between two liver biopsies.


METHODS
Clinical charts of 112 chronic hepatitis C patients were retrospectively analyzed, whereas liver biopsies were revised. Immunohistochemical detection of interferon receptor was based on the Envision-Peroxidase System.


RESULTS
In the multivariate analysis, the variables in the age at first biopsy, ALT levels, presence of lymphoid aggregates and siderosis were the determinants of the best model for predicting the severity of the disease. The direct progression rate of hepatic structural lesions was significantly higher in untreated patients, intermediate in treated non-responders and lower in treated responders to antiviral therapy (non-treated vs responders, 0.22 +/- 0.50 vs -0.15 +/- 0.46, P = 0.0053). Immuno-expression of interferon receptor is not a relevant factor.


CONCLUSIONS
The best predictors of the progression of fibrosis are age at the first liver biopsy, extent of ALT elevation, inflammation at liver histology and hepatic siderosis. Antiviral treatment is effective in preventing the progression of liver structural lesions in chronic hepatitis C patients.
Mendes
Liliana S C
LS
Department of Gastroenterology, University of Sao Paulo School of Medicine, R. Silva Correia, 153, ap 41, 04537-040 Sao Paulo-SP, Brazil.
Nita
Marcelo E
ME
Ono-Nita
Suzane K
SK
Mello
Evandro S
ES
da Silva
Luiz Caetano
LC
Alves
Venancio A F
VA
Carrilho
Flair J
FJ
D000328:Adult; D001706:Biopsy; D018450:Disease Progression; D005260:Female; D019698:Hepatitis C, Chronic / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D007150:Immunohistochemistry; D008103:Liver Cirrhosis / Q000473:pathology / Q000503:physiopathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D017471:Receptors, Interferon / Q000378:metabolism; D012044:Regression Analysis
D017471:Receptors, Interferon