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Assessment of histological features in chronic hepatitis C
Katalin Jármay1, Gizella Karácsony, Zsófia Ozsvár
1First Department of Internal Medicine, Faculty of Health Sciences, Albert Szent-Györgyi Medical University, Szeged, P.O. Box 469, Hungary, H-6701.
Background/Aims:
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.
Methodology:
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.