Liver histology in patients on hemodialysis with chronic hepatitis C viral infection

Abstract

Hepatitis C virus (HCV) is a major cause of chronic liver disease in patients on hemodialysis. As no useful noninvasive predictors of disease activity and fibrosis have been found, liver biopsy is essential in these patients to accurately assess the severity of disease and thus the prognosis and plan management. The present study was undertaken to assess the degree of severity of necroinflammatory changes and fibrosis in liver biopsies of patients on hemodialysis with chronic HCV infection. Liver biopsies obtained from 45 patients on hemodialysis with serological evidence of chronic hepatitis C were studied. The grading of necroinflammatory activity and staging of fibrosis were histologically assessed. The majority of patients (30, i.e. 66.7%) had mild disease with mild inflammatory activity and stage 0, 1 or 2 fibrosis. There was no significant correlation between the degree of fibrosis and the age of the patients (rs = 0.015), the duration of hemodialysis (rs = 0.047) or the presence of steatosis (rs = 0.064). There was a positive correlation between the presence of bile ductular proliferation and the severity of fibrosis (rs = 0.612). It was concluded that chronic HCV infection in hemodialysis patients is relatively mild early in its course. However, serial follow-up liver biopsies are mandatory to plan appropriate intervention strategies.

Histological Spectrum of Idiopathic Noncirrhotic Portal Hypertension in Liver Biopsies From Dialysis Patients

“…20 Likewise, albumin dialysis temporarily reduced portal pressure in patients with acute alcoholic hepatitis with risk of variceal bleeding. 35 Mysorekar et al 36 studied liver biopsies of HCV patients on hemodialysis and reported that the necroinflammatory activity is mild in this group. Similarly, in our cases, the portal and lobular inflammation was minimal to mild.…”

Prevalence of Hepatitis B and Hepatitis C in Tertiary Care Center of Northeren India

“…Though reports on the prevalence of HBV and/or HCV infection among blood donors [15] and in patients with certain clinical conditions [16,17] are available, prevalence among general population in India is sparse.…”

Transient elastography as a screening tool for liver fibrosis in a large hemodialysis population

“…The cut-off value of LSM for diagnosing clinically relevant fibrosis in this study was obtained from non-uremic populations131415. However, studies with liver biopsy and TE performed in hemodialysis patients are scarce, and all of the previous studies of this type involved HCV-infected patients29303132333435. Therefore, we used FIB-4 as a comparator test for clinically relevant fibrosis, and we found that the diagnostic performance of the LSM for FIB-4-identified clinically relevant fibrosis is relatively good (AUROC > 0.8).…”