Association between histological findings, aminotransferase levels and viral genotype in chronic hepatitis C infection

Abstract

Introduction:The genomic heterogeneity of hepatitis C virus (HCV) influences liver disorders. This study aimed to determine the prevalence of HCV genotypes and to investigate the influence of these genotypes on disease progression. Methods: Blood samples and liver biopsies were collected from HCV-seropositive patients for serological analysis, biochemical marker measurements, HCV genotyping and histopathological evaluation. Results: Hepatitis C virus-ribonucleic acid (HCV-RNA) was detected in 107 patients (90.6% with genotype 1 and 9.4% with genotype 3). Patients infected with genotype 1 exhibited higher mean necroinflammatory activity and fibrosis. Conclusions: HCV genotype 1 was the most prevalent and was associated with greater liver dysfunction.Keywords: Hepatitis C virus. Genotype. Histopathology.Hepatitis C virus (HCV) infection is often asymptomatic, but it is chronic in a large (85%) proportion of cases. Approximately 20% of individuals with chronic HCV develop liver damage, cirrhosis or cancer 1 .In Brazil, the seroprevalence of HCV is moderate, although rates vary among different regions of the country 2 . Genotype 1 is predominant, followed by genotypes 3 and 2 3 . In the State of Pará, the overall prevalence ranges from 0.5 to 2% among blood donor candidates 4 , and the genotype distribution is similar to that reported elsewhere in Brazil 5 .Hepatitis C virus genotype 1 has been associated with severe liver damage and the response to treatment 6 . However, other studies were unable to confirm this association 7 . Brazilian studies correlating the different HCV genotypes with histological and clinical presentation are scarce and have not confirmed an association between liver disease severity and HCV genotype 8,9 .The objectives of this study were to determine the prevalence of HCV genotypes in patients with chronic hepatitis C in the State of Pará, Brazil and to investigate the influence of these genotypes on the biochemical and histopathological parameters of the disease.

Prevalence of hepatitis C virus genotypes in the State of Pará, Brazil

“…Previous records have shown that advanced liver disease and hepatocellular carcinoma are more common in HCV patients with genotype 1 7 . Although this study clearly reflects the genotypic diversity of HCV in the population of the State of Pará, its results may reflect differences in the time of HCV acquisition, which in turn may influence the peak period of the viral load and viral complications, including cirrhosis and hepatocellular carcinoma.…”

“…Each genotype is divided into subtypes, and there is variation in the prevalence of these genotypes among different continents and different regions of the same country 6 . Following the distribution pattern in the Americas, Brazil has a higher prevalence of genotype 1 (64.0%), followed by genotypes 3 (31.0%), 2 (4.0%), and finally 4 and 5 (both < 1.0%) 7 .…”

Are Liver Transaminases and Hepatitis C Virus-RNA Viral Loads Reliable Markers for Estimating Liver Fibrosis in Patients Recently Diagnosed with Hepatitis C? Evaluation of the Data of Ninety-five Young and Middle-aged Males in a Genotype-1b Prevalent Country

“…Similarly to our results, Shahid et al (13) showed that AST and ALT significantly correlated with the stages of fibrosis. However, there are some studies in literature which demonstrates that AST was better than ALT as a marker of the progression of liver damage, or that both transaminases showed no correlation with fibrosis (11,14,15,16,17,18).…”