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Eur J Gastroenterol Hepatol 2000 Mar;12(3):299-304 Related
Articles, Books
Relationship between genotypes of hepatitis C virus and
histopathological manifestations in chronic hepatitis C
patients.
Adinolfi LE, Utili R, Andreana A, Tripodi MF, Rosario P, Mormone G,
Ragone E, Pasquale G, Ruggiero G
Institute of Medical Therapy, Faculty of Medicine, Second
University of Naples, Italy.
OBJECTIVE: The aim of this study was to assess the relationship
between HCV genotype and histological liver injury.
DESIGN: Prospective study on a cohort of patients with biopsy
proven chronic hepatitis C.
SETTING: University medical centre.
PARTICIPANTS: Enrolled were 324 consecutive patients (male 197,
median age 52 years, range 19-68; chronic hepatitis, 224;
cirrhosis, 100).
METHODS: HCV genotype was determined by the INNO LiPA assay and
HCV RNA levels by the bDNA assay. The histological features were
scored according to the histology activity index.
RESULTS: The distribution of HCV genotypes was 1a, 4.6%; 1b,
52.4%; 2a/c, 27%; 3a, 8%; 4, 2%; mixed, 6%. Serum HCV RNA levels
were similar for all genotypes. There was no difference in the
distribution of HCV genotypes between patients with chronic
hepatitis and those with cirrhosis. Patients with genotype 1b and
those with type 2a/c showed a similar prevalence of cases of
cirrhosis (33% versus 31%, respectively). In addition, in a
subgroup of 102 patients with an established date of infection, the
progression to cirrhosis occurred with a similar length of time for
HCV type 1b and 2a/c (median 16 versus 15 years, respectively).
Patients with HCV genotype 2a/c or mixed genotype showed a higher
histology activity index than those with type 1b (P less than
0.01), whereas there was no difference in the fibrosis score for
the different genotypes. Patients with genotype 3a showed a
significantly higher prevalence of steatosis compared to those
infected with other genotypes. Alanine aminotransferase (ALT)
values were higher in patients with HCV type 2a/c, 3a and mixed
genotype than those with type 1 (P less than 0.002).
CONCLUSIONS:
The data indicate that there is no association between a particular
HCV genotype and the progression to cirrhosis, and that specific
genotypes are associated with distinct histopathological and
biochemical manifestations although none of them is correlated with
an increase of the fibrosis stage.
PMID: 10750650, UI: 20212688
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