Correlation of Pathohistological Changes and Serology Parameters in Chronic Hepatitis C - Zdravlje, medicina, lijecenje, zdravstveni portal

Correlation of Pathohistological Changes and Serology Parameters in Chronic Hepatitis C

Correlation of Pathohistological Changes and Serology Parameters in Chronic Hepatitis C
Bisera Gogov, Zora Vukobrat-Bijedic
Med Arh. 2012; 66(3): 181-184

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Introduction: Viral Hepatitis C, formerly known as non A–non B hepatitis, as a separate clinical entity described in 1975 is most often reported in patients who received blood transfusions, and also called it post transfusion hepatitis. Aim of the study: Goal was to quantify the number of HCV RNA copies by PCR method, histologically determine the stage of fibrosis and degree of necroinflammatory activity in biopsies of liver parenchyma, and compare the histopathological changes with the number of the virus copies. Material and methods: The study was prospective and involved 50 patients suffering from chronic hepatitis C of viral etiology. All patients underwent liver biopsy and the specimens were patohistologically investigated to determine the stage of fibrosis score, and necroinflammatory activities. In every case was determined the concentration of AST, ALT, bilirubin, CBC, DR, and all underwent percutaneous ultrasonography and gastroscopy. We performed genotyping of viruses and virus quantification of HCV RNA-PCR. Results: The study showed that women were older than men. The stage of fibrosis and degree of necroinflammatory activities were higher in women than men, meaning that older people carry the virus longer, increasing the number of virus copies the disease lasted longer. According to the etiology of infection the patients who were infected by blood transfusions had a higher stage of fibrosis. Score of necroinflammatory activity was significantly dependent on variables AST with p=0.02 and ALT with p=0026. Conclusion: Our research has shown that the stage of fibrosis was significantly dependent on alanine aminotransferases, duration of infection, number of virus copies and mode of infection. Patients who received blood transfusions, had the longest duration of infection, higher stage of fibrosis and degree necroinflammatory activity.


1. Vukobrat-Bijedić Z. Virusni hepatitis, dijagnostika terapija i komplikacije, 2008.

2. Asselah T, Ripault MP, Castelnau C, Giuly N, Marceliln P. The current status of antiviral therapy of chronic hepatitis. Br J Clin Virol. 2005; 34(Suppl 1): S 115-24.

3. Bartenschlager R, Lohmann V. Replication of hepatitis C virus. J. Gen Virol Hepat. 2000; 81: 1631-1648.

4. Braun N. Epoetin alfa treatment for acute anaemia during interferon plus ribavirin combination therapy for chronic hepatitis C. J Virol Hepat. 2004; 11(3): 191-197.

5. Cacoub P, Ratziu V. Myers RP. et al. Multivirc Group. Impact of tretment of extra hepatic manifestations in patients with chronic hepatitis C. J Hepatol. 2002; 36: 812-818.

6. Castera L, Hezode C, Roudot-Thorval F. et al. Worsening of steatosisis an independent factor of fibrosis progression in untrieted with chronic hepatitis C and pired liver biopsies. Gut. 2003; 52: 288-292.

7. Dhalluin C, Ross A, Leuthold La, Foser S, Gsell B, Muller F, Senn H. Structural and biophysical characterisation of the 40 kDa PEG- interferon- alpha 2ª and its individual positional isomers. Bioconjug Chem. 2005; 16(3): 504-517.

8. Kee KM, Lee CM, Wang JH, Tung HD, Changchien CS, Lu SN, Wang PW. Thyroid disfunction in patients with chronic hepatitis C reciving a combined therapy of interferon and ribavirin: incidenceassociated factors and prognosis. J Gastroenterol Hepatol. 2006; 21(1Pt2): 319-326.

9. Kim WR. Global epidemiology and burden of hepatitis C. Microbes Infecton. 2002; 4: 1219-1225.

10. Pell N, Torre F, Delffino A, Basso M, Picciotto A. Soluble tuimor necrosis factor-related liquand (s TRAIL) levels and kinetics during inviral tretment in chronic hepatitis C. J Hepatol. 2002; 37(1): 150-153

11. Hughes CA, Shafran SD. Tretment of hepatitis C in HIV – Patients Coinfected Patients. Ann Pharmacother. 2006; 40(3): 479-489.

12. Conry-Cantiena C, Van Raden, Gibble J, Melpolder J, Shakil AO, Viladomiu L. et al. Routes of infection, viremia, and liver disease in blood donors found to have hepatitis C virus infection. N Engl J Med. 1996; 334(26): 1691-1696.

13. Pradat P, Alberti A, Poynard T, Esteban JI, Weiland O, Marcellin P, et al. Predictive value of ALT levels for histologic findings in chronic hepatitis C: a European collaborative study. Hepatology. 2002; 36(4 Pt 1): 973-977.

14. Puoti C, Castellacci R, Zaltron Sstornaliunolo G, Bergami N et al. Histological and virological features and follow-up of hepatitis C virus carriers with normal aminotransveraze levels: the Italian prospective study of the asymptomatic C carriers (ISACC). J Hepatol. 2002; 37(1): 117-123.

15. Silva GF, Coelho KIR, Nishimura NF, Suarez EC. Progression of Liver Fibrosis in Blood Donors Infected with Hepatitis C virus. Gastroenterol. 2004 Dec; 13(4): 290-297.

16. Svirth N, Delić D, Simonović J, Jeftović Đ, Dokić Lj, Gvozdenović E, Boričić I, Terzić D, Pavić S, Nešković G, Zerjev S, Urban V. Hepatitis C virus genotypes in Serbia and Montenegro. The prevalence and clinical significance. World J Gastroenterol. 2007 Jan; 15(5): 355-360.

17. Di Bisceglie AM, Thompson J, Smith-Wilkaitis N, Brunt EM, Bacon BR. Combination of interferon and ribavirin in chronic hepatitis C: re-treatment of nonresponders to interferon. Hepatology. 2001; 33(3): 704-707.

18. Puoti C. HCV carriers with persistently normal aminotransferase levels: normal does not always mean healthy. J Hepatol 2003;38(4):529-32

19. Morisco F, Leone D, Tuccillo C, Iasevoli P, Sessa G, De Luise G, et al. Subjects positive for hepatitis C virus RNA with normal aminotransferase levels, a “trompe l’oeil” clinical picture? Dig Liver Dis. 2000; 32(7): 598-602.

20. Bacon BR. Treatment of patients with hepatitis C and normal serum aminotransferase levels. Hepatology. 2002; 36(5,Suppl 1): S 179-84.

21. Martinot-Peignoux M, Boyer N, Cazals-Hatem D, Pham BN, Gervais A, Le Breton V, et al. Prospective study on anti-hepatitis C virus-positive patients with persistently normal serum alanine transaminase with or without detectable serum hepatitis C virus RNA. Hepatology. 2001; 34(5): 1000-1005.

22. Tsuji K, Yamasaki K, Yamanishi M, Kawakami M, Shirahama S. Risk of alanine aminotransferase flare-up among asymptomatic hepatitis C virus RNA carriers: a 10-year follow-up study. J Gastroenterol Hepatol. 2001; 16(5): 536-540.

23. NIH Consensus Guidelines – Management of Hepatitis C. NIH, Bethesda, 2002.

24. Shiffman MI, Stewart CA, Hofmann CM, Contos MJ, Luketic VA, Sterling RK, et al. Chronic with hepatitis C virus in patients with elevated or p ersistently normal serum alanine aminotransferase levels: comparison of hepatic histology and response to interferon therapy. J Infect Dis. 2000; 182(6): 1595-1601.

25. Akkaya O.,Kiyici M.,Yilmaz Y., Ulukaya E., Yerci O., Clinical significance of activity of ALT enzyme in patients with hepatitis C virus. World J Gastroenterol. 2007, November 7; 13 (41):5481-5485.

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