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[Liver histology in chronic hemodialysis patients infected with hepatitis C virus]
A Iotti1, M A Avagnina, O Mandó
1Servicio de Patología, Centro de Educación Médica e Investigacíones Clínicas (CEMIC), Buenos Aires, Argentina.
Insights
Chronic renal failure patients with Hepatitis C Virus infection show similar liver histology to non-CRF patients. Biopsies revealed varying degrees of chronic hepatitis and fibrosis, with common lesions like lymphoid nodules and steatosis.
Area of Science:
- Nephrology
- Hepatology
- Virology
Context:
- Chronic renal failure (CRF) patients often have co-infections.
- Hepatitis C Virus (HCV) is a common comorbidity in CRF.
- Liver involvement in CRF patients with HCV requires detailed histologic assessment.
Purpose:
- To analyze liver biopsy findings in CRF patients with HCV.
- To correlate histologic features with disease severity.
- To compare HCV-related liver histology in CRF versus non-CRF patients.
Summary:
- Twenty-one CRF patients positive for HCV underwent liver biopsy.
- Histologic analysis revealed chronic hepatitis in all cases, with 2 progressing to cirrhosis.
- Common findings included lymphoid nodules, ductal epithelium lesions, and steatosis, similar to non-CRF HCV patients.
Impact:
- Provides insight into the liver pathology of HCV in the context of CRF.
- Highlights the need for monitoring liver health in dialysis patients.
- Suggests HCV affects CRF patients' livers similarly to the general population.
Abstract:
Liver biopsies were analyzed in 21 patients with chronic renal failure (CRF) who tested positive for Hepatitis C Virus (HCV), using Elisa II and/ or PCR. The study included 14 men and 7 women, the average age being 41 years old (range: 20-65). The average span of time under dialysis was 64 months (range: 12-192). Hbs ag. was positive in six patients. Patients underwent biopsy for showing persistent rise of transaminase for more than 6 months. The modified Knodell Index was used to grade hepatic lesions. All biopsies showed chronic hepatitis, of which 2 were associated with cirrhosis. Eight patients were infected with mild chronic hepatitis, ten were infected with moderate chronic hepatitis, and only three patients had a severe lesion. Fibrosis was mild in 13 cases, moderate in 6, and 2 had cirrhosis. Chronic Hepatitis C characteristic lesions analysis showed lymphoid nodules in 6 cases (29%), ductal epithelium lesions in 7 (33%), and steatosis in 7 (33%). Chronic HCV infection in our patients seems to have histologic characteristics similar to those reported in HCV positive non CRF patients.