Hepatitis C-virus genotype 1B is associated with more extensive
fibrosis but not inflammatory activity in liver biopsies of
patients with chronic hepatitis C.
Several studies have reported on the increased prevalence of
cirrhosis in patients infected with hepatitis C virus (HCV)
genotype 1b. We studied the relationship between HCV genotypes and
the severity of liver disease by histologically grading
inflammatory activity and staging fibrosis in liver biopsies (J
Hepatol 1995;22: 606). Methods: Pretreatment liver biopsies of 100
patients with chronic hepatitis C (evaluated for treatment with
interferon alfa-2b) were graded for piece meal necrosis (score
0-4), confluent necrosis (0-6), focal necrosis (0-4), portal
inflammation (0-4) and staged for fibrosis (0-6) by a pathologist
(L.B.), blinded for the viral genotypes and clinical data. Results:
mean age, mean scores:
HCV-genotype 1a 1b 2a 3a 4-6 *p=
patients (n =) 10 30 17 35 8
age (years) 32.7 47.7* 50.3* 35.4 34.4 <0.01
piece meal necr. 2.1 2.4 2.4 2.3 2.1 0.80
focal necrosis 3.2 2.9 3.1 3.1 2.1* 0.02
portal inflamm. 2.6 2.3 2.7 2.3 2.3 0.37
fibrosis 1.7 3.2* 2.4 2.1 2.1 0.04
Infection with HCV-genotypes 4-6 is associated with less focal
necrosis, but otherwise there is no difference of the inflammatory
activity caused by the various HCV-genotypes. In contrast infection
with type 1b is associated with significanly higher scores of
fibrosis. There is no correlation between the age of the patients
and fibrosis scores in their liver biopsies (Spearman's rho=0.17,
p=NS).
Conclusion: The advanced histological stage of patients infected
with HCV-genotype 1b does not seem to depend on the older age
(supposedly longer duration of disease) of these patients but
rather on the more aggressive behaviour of this particular viral
genotype.
From: American Gastroenterology Association Digestive Disease
Week meeting in Washington in May 1997
B. Meyer-Wyss*, L. Bianchi", A. Mantegani&, D. Lavanchy&,
N.Dolivo+, J.J.Gonvers+, B.Lauterburg£, R.Meier"", B.Miazza',
E.L.Renner£, J.Reichen£, H.P.Wirth$, G.Zala$. St.
Claraspital*, Basel; Hofstetten", Div.of Immunology&,
University Hospitals of Bern£, Lausanne&+, Zurich$,
Kantonsspital Liestal"", Ospedale Civico, Lugano, Switzerland.
This work was supported in part by ESSEX Chemie AG, Lucerne,
Switzerland
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