Chronic hepatitis C: hepatic fibrosis evolution after ineffective specific treatment.
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.
Widman
Azzo
A
Department of Digestive Surgery, Clinical Hospital of Sao Paulo University's Medical School, Sao Paulo, Brazil. azzowidman@yahoo.com.br
Mendes-Corrêa
Maria Cássia Jacyntho
MC
Zanoto
Arnaldo
A
Capacci
Maria de Lourdes
Mde L
de Mello
Evandro Sobroza
ES
Saad
Willian Abrão
WA
Barone
Antonio Alci
AA
Gama-Rodrigues
Joaquim José
JJ
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