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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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