title: Clinicopathological features and genotype distribution in patients with hepatitis C virus chronic liver disease.
abstract: OBJECTIVE
  Hepatitis C virus (HCV) genotype influences the severity of disease and response to therapy. This retrospective study examined the clinical and histological features and the genotype distribution in biopsied patients with HCV related chronic liver disease.
  
  
  METHODS
  Of 105 biopsies from patients with HCV infection, 96 from patients with chronic liver disease were reviewed. The Ishak scoring system was used for histological analysis.
  
  
  RESULTS
  Genotype 3 was most common accounting for 77.1%, and genotype 1 for 9.4% of cases. There was no significant association of transaminase levels, viral load or necro-inflammatory activity score with genotype. A severe degree of fibrosis was seen in 77.8% cases of genotype 1 and in 63.5% of genotype 3 (p=0.76). Variable degrees of steatosis were noted in 68.8% of cases. However, severe steatosis was noted only in genotype 3 (7 cases). Serum transaminase levels did not correlate with either histological activity (p=0.43) or degree of fibrosis (p=0.72). Severe fibrosis / cirrhosis was seen in 74.24% of patients above 40 years of age as compared to 33.3% of patients below 40 years (p=0.001). The frequency of Mallory hyaline was significantly different between genotypes 1 and 3 infection (P<0.001).
  
  
  CONCLUSIONS
  This study confirms the preponderance of genotype 3 in Indian patients with HCV related chronic liver disease. Severe steatosis was seen only in genotype 3 and Mallory hyaline was very common in genotype 1. The small numbers of patients in non genotype 3 could be a reason for the apparent lack of histological differences between different HCV genotypes. Severe fibrosis seen in older age groups confirms that HCV infection is progressive and major acceleration of the disease process occurs after 40 years of age.
authors.affiliation: Department of Pathology, Christian Medical College, Vellore, India.
authors.forename: Rachel
authors.initials: R
authors.lastname: Abraham
authors.forename: Banumathi
authors.initials: B
authors.lastname: Ramakrishna
authors.forename: Avinash
authors.initials: A
authors.lastname: Balekuduru
authors.forename: Hubert Darius J
authors.initials: HD
authors.lastname: Daniel
authors.forename: Priya
authors.initials: P
authors.lastname: Abraham
authors.forename: C Eapen
authors.initials: CE
authors.lastname: Eapen
authors.forename: George
authors.initials: G
authors.lastname: Kurian
mesh_terms: D001706:Biopsy; D004279:DNA, Viral / Q000032:analysis*; D003937:Diagnosis, Differential; D018450:Disease Progression; D005234:Fatty Liver / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000473:pathology / Q000821:virology; D006801:Humans; D007194:India / Q000453:epidemiology; D008099:Liver / Q000473:pathology* / Q000821:virology; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011506:Proteins / Q000378:metabolism; D012189:Retrospective Studies; D012720:Severity of Illness Index; D000637:Transaminases / Q000097:blood
chemical_list: D004279:DNA, Viral; C027596:Mallory body protein, human; D011506:Proteins; D000637:Transaminases
references.citation: Gut. 2004 Mar;53(3):451-5
references.pmid: 14960533
references.citation: Trop Gastroenterol. 2007 Jul-Sep;28(3):99-104
references.pmid: 18383996
references.citation: J Hepatol. 2002 Dec;37(6):837-42
references.pmid: 12445426
references.citation: Ann Intern Med. 1995 Feb 1;122(3):161-8
references.pmid: 7810932
references.citation: Indian J Med Microbiol. 2005 Oct;23(4):273-4
references.pmid: 16327131
references.citation: Hepatology. 1997 Mar;25(3):735-9
references.pmid: 9049227
references.citation: J Viral Hepat. 2006 Mar;13(3):199-205
references.pmid: 16475996
references.citation: Am J Gastroenterol. 1996 Aug;91(8):1516-22
references.pmid: 8759653
references.citation: J Trop Med Hyg. 1995 Jun;98(3):161-5
references.pmid: 7783272
references.citation: Semin Liver Dis. 2005 Feb;25(1):52-64
references.pmid: 15731997
references.citation: Histopathology. 2001 Aug;39(2):119-24
references.pmid: 11493327
references.citation: Am J Gastroenterol. 2004 Feb;99(2):286-91
references.pmid: 15046219
references.citation: Eur J Gastroenterol Hepatol. 2001 May;13(5):501-6
references.pmid: 11396528
references.citation: World J Gastroenterol. 2007 May 7;13(17):2416-26
references.pmid: 17552024
references.citation: J Clin Virol. 2003 Jan;26(1):61-9
references.pmid: 12589835
references.citation: Hepatology. 1996 Aug;24(2):289-93
references.pmid: 8690394
references.citation: Indian J Gastroenterol. 2005 Mar-Apr;24(2):72-3
references.pmid: 15879655
references.citation: Eur J Gastroenterol Hepatol. 2000 Mar;12(3):299-304
references.pmid: 10750650
references.citation: Diagn Microbiol Infect Dis. 2008 Aug;61(4):408-14
references.pmid: 18455899
references.citation: J Hepatol. 1995 Jun;22(6):696-9
references.pmid: 7560864
references.citation: J Viral Hepat. 2006 Nov;13(11):775-82
references.pmid: 17052278
references.citation: J Korean Med Sci. 2001 Oct;16(5):585-91
references.pmid: 11641527
references.citation: Am J Gastroenterol. 1997 Oct;92(10):1788-92
references.pmid: 9382037
references.citation: Dig Dis Sci. 2000 Jan;45(1):182-7
references.pmid: 10695633
references.citation: World J Gastroenterol. 2006 Nov 14;12(42):6756-65
references.pmid: 17106922
references.citation: J Viral Hepat. 2000 Mar;7(2):124-9
references.pmid: 10760042
references.citation: J Hepatol. 2001 May;34(5):730-9
references.pmid: 11434620
references.citation: Gastroenterology. 2000 Apr;118(4):760-4
references.pmid: 10734027
references.citation: J Hepatol. 2003 Feb;38(2):223-9
references.pmid: 12547412
references.citation: J Med Virol. 2006 Apr;78(4):452-8
references.pmid: 16482560
references.citation: Braz J Infect Dis. 2005 Apr;9(2):142-9
references.pmid: 16127590
references.citation: Hepatogastroenterology. 2008 May-Jun;55(84):1047-54
references.pmid: 18705326