title: Chronic hepatitis C: hepatic fibrosis evolution after ineffective specific treatment.
abstract: OBJECTIVE
  Specific treatment of chronic hepatitis C is effective in 50% of patients, improving the liver's fibrosis, necroinflammatory changes and steatosis. However, in patients still viremic after treatment the extension of these benefits remains doubtful. The evolution of the disease in this group and its relationship to demographic data, biometric indices and time lapse between biopsies was evaluated.
  
  
  METHODS
  In 141 patients, paired biopsies were classified and compared according to fibrosis grading. Necroinflammation, steatosis, demographic data (age and gender), body mass index (BMI) and time lapse between biopsies were compared with fibrosis grading.
  
  
  RESULTS
  The grade of fibrosis of the patients, after approximately 3.5 years time lapse between biopsies, could be classified into 4 groups; Improved: 29 (20.0%), Unaltered: 64 (45.0%), Worsened: 48 (34%) and Cirrhotic: 14 (9.93%). For necroinflammation, the Improved/Unaltered groups were statistically similar but different from the Worsened and Cirrhotic. The mean age, BMI and time lapse between biopsies were statistically similar in all groups. Steatosis occurred in 35 (24.82%) between biopsies and its incidence was reduced in the Worsened and Cirrhotic groups.
  
  
  CONCLUSIONS
  Fibrosis turned into cirrhosis in a significant number of patients, after a short time lapse. The reverse correlation of steatosis to fibrosis and its occurrence during the time lapse between biopsies suggests it might induce hepatic necrosis and contribute to fibrogenesis.
authors.affiliation: Department of Digestive Surgery, Clinical Hospital of Sao Paulo University's Medical School, Sao Paulo, Brazil. azzowidman@yahoo.com.br
authors.forename: Azzo
authors.initials: A
authors.lastname: Widman
authors.forename: Maria Cássia Jacyntho
authors.initials: MC
authors.lastname: Mendes-Corrêa
authors.forename: Arnaldo
authors.initials: A
authors.lastname: Zanoto
authors.forename: Maria de Lourdes
authors.initials: Mde L
authors.lastname: Capacci
authors.forename: Evandro Sobroza
authors.initials: ES
authors.lastname: de Mello
authors.forename: Willian Abrão
authors.initials: WA
authors.lastname: Saad
authors.forename: Antonio Alci
authors.initials: AA
authors.lastname: Barone
authors.forename: Joaquim José
authors.initials: JJ
authors.lastname: Gama-Rodrigues
mesh_terms: D000328:Adult; D001706:Biopsy; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D017211:Treatment Failure