Comparative assessment of liver fibrosis by computerized morphometry in naïve patients with chronic hepatitis B and C

Abstract

As compared to CHB, amount of fibrosis is greater in CHC for F ≤ 2 patients, mainly because of higher perisinusoidal fibrosis. These data illustrate difficulty to assess early fibrosis stages by non-invasive methods, and support the need for specific cut-offs in CHB.

Quantification of portal–bridging fibrosis area more accurately reflects fibrosis stage and liver stiffness than whole fibrosis or perisinusoidal fibrosis areas in chronic hepatitis C

“…A few morphometric studies have focused on the different fibrosis compartments in CHC, [24][25][26][27][28] but owing to variations in methods, patient populations, and study goals, the results are hardly comparable to ours and between each other. The largest series in nontreated patients with chronic viral hepatitis showed that perisinusoidal fibrosis was twice more prominent in chronic hepatitis C than in chronic hepatitis B in early fibrosis stages (Fr2).…”

“…The largest series in nontreated patients with chronic viral hepatitis showed that perisinusoidal fibrosis was twice more prominent in chronic hepatitis C than in chronic hepatitis B in early fibrosis stages (Fr2). 28 This is an interesting finding as, unlike fibrosis in alcoholic or nonalcoholic steatohepatitis, perisinusoidal fibrosis has not been classically described as a significant lesion in CHC and is not included in the most used histological scores. In addition, a good correlation was observed between perisinusoidal fibrosis and stellate cell activation highlighted by a-smooth muscle actin immunostaining.…”

“…In addition, a good correlation was observed between perisinusoidal fibrosis and stellate cell activation highlighted by a-smooth muscle actin immunostaining. 28 Stellate cell activation in CHC is likely, as in vitro interactions have been described between these cells and HCV components 29,30 and results in progressive deposition of type I and III collagen fibrils that are easily identified with the picrosirius stain. 7 In our study, we defined perisinusoidal fibrosis as picrosiriusstained fibrils separated by liver cell plate.…”

“…Nonetheless, our study clearly showed that a detectable and pathologic perisinusoidal collagen network is present in early fibrosis stages (F0 to F2) in CHC, with a quite wide range of values, as previously observed. 28 The mere quantification of fibrosis areas cannot describe the spatial organization of liver fibrosis. We thus provided by fractal analysis a quantitative index, the fractal dimension, that reflects the geometry of complex structures in space.…”

MR Elastography for the Assessment of Hepatic Fibrosis in Patients with Chronic Hepatitis B Infection: Does Histologic Necroinflammation Influence the Measurement of Hepatic Stiffness?

“…had control of the data. Between March 2012 and October 2013, 173 consecutive Asian patients with chronic HBV infection referred to the division of infectious diseases of our Asian hospital for medical treatment were initially included in the study if (a) they were 18 years old or older without known or recent pregnancy, (b) they planned to undergo a biopsy during their hospitalization or underwent histologic examination within 3 months of hospitalization, (c) they had HBV surface antigen for more than 6 months and serum HBV DNA levels higher than 10 5 copies per milliliter or persistent or intermittent increase in other studies have demonstrated histologic differences between chronic HCV and chronic HBV fibrotic patterns, noting higher perisinusoidal fibrosis in chronic HCV infection for patients with a fibrosis stage ("F" stage) of F2 (8). Hence, when comparing hepatic tissue with the same severity of fibrosis shown by histopathologic findings in patients with chronic HCV and chronic HBV infections, chronic HBV-infected tissue might have less collagen and more variable inflammatory changes than tissue with chronic HCV infection.…”