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Chronic hepatitis in patients with active hepatitis B virus and hepatitis C virus combined infections: a histological
D Villari1, M Pernice, S Spinella
1Dipartimento di Patologia Umana, Università di Messina, Italy.
Insights
Histological examination of liver tissue from patients with combined hepatitis B (HBV) and hepatitis C (HCV) infections revealed no unique patterns or increased disease severity compared to single infections. Findings suggest combined HBV and HCV infections do not present distinct histological features.
Area of Science:
- Hepatology
- Virology
- Histopathology
Background:
- Chronic hepatitis B (HBV) and hepatitis C (HCV) are significant global health concerns.
- Coinfection with HBV and HCV can influence disease progression and treatment outcomes.
- Understanding the distinct histological manifestations of coinfection is crucial for accurate diagnosis and management.
Purpose of the Study:
- To investigate unique histological changes in liver biopsy specimens from patients with combined HBV and HCV chronic infections.
- To compare the histological patterns of combined HBV/HCV infection with those of single HBV or HCV infections.
Main Methods:
- Liver biopsy specimens from 14 patients with combined HBV and HCV infection were analyzed.
- Control groups included 14 patients with HBV alone and 14 with HCV alone, matched for demographics and diagnosis.
- Histological features were systematically scored by two independent pathologists.
Main Results:
- No peculiar histological pattern was identified in the combined HBV and HCV infection group.
- Most microscopic features were common across all three groups (combined, HBV alone, HCV alone).
- Specific findings like bile duct lesions and lymphoid follicles were noted in HCV and combined groups, while ground-glass hepatocytes appeared in HBV and combined groups.
Conclusions:
- Combined HBV and HCV chronic infection does not exhibit distinct histological patterns in liver tissue.
- Coinfection does not appear to represent a more severe form of liver disease compared to single viral hepatitis.
- The presence of specific lesions does not rule out coinfection with both HBV and HCV.
Objectives:
To evaluate whether peculiar histological changes are present in liver tissue of patients with chronic hepatitis by hepatitis B and hepatitis C (HBV and HCV) virus combined infections.
Methods:
We studied liver biopsy specimens from 14 HB surface antigen/anti-HCV-positive patients consecutively admitted to hospital because of chronic liver disease from 1987 to 1992. Alcohol abusers, drug addicts, hepatitis delta virus- and HIV-infected subjects were excluded from the study. All of them were positive for serum HBV-DNA and/or intrahepatic HB core antigen and for serum HCV-RNA. Histological examination showed mild or moderate chronic hepatitis in nine cases and severe chronic hepatitis with cirrhosis in five cases. Two additional sets of liver biopsy specimens were also included in the study, consisting of liver samples from 14 patients with chronic liver disease due to active HBV infection alone (group B) and from 14 patients with active HCV infection alone (group C). Cases from group B and C matched for age, sex, and histological diagnosis with those from group B + C. Histological patterns of all the liver specimens of the three groups were re-examined by two authors who scored the found features using a scale from 0 to 3.
Results:
No peculiar histological pattern was revealed in group B + C, and most of the detected microscopic features were similarly present in all three groups. Bile duct lesions and well defined lymphoid follicles were found only in liver samples of patients from groups C and B + C. Ground-glass hepatocytes were observed only in cases from the groups B and B + C.
Conclusions:
Histological examination of liver tissue from patients with chronic HBV and HCV combined infection does not show either typical patterns or evidence that this subgroup of chronic viral hepatitis is a more severe form of liver disease than that caused by a single virus infection. The observation in liver samples of peculiar lesions by HBV or HCV infection does not exclude a combined infection by both viruses.