The relationship of histology to genotype in chronic HCV infection

Abstract

Booth JCL, Foster GR, Levine T, Thomas HC, Goldin RD. The relationship of histology to genotype in chronic HCV infection.Abstract: The histological description of chronic hepatitis is undergoing considerable change at present. It has become important to define chronic hepatitis aetiologically and then define levels of necro-inflanmatory change (grade) and fibrosis (stage). The aim of this study was to compare the ability of different histological scoring systems to detect differences in the pathological changes associated with infection with the different HCV genotypes that are known to have different natural histories. The histological appearances of liver biopsies from 29 HCV infected patients were compared by the Knodell histological activity index (HAI), modified histological activity index and the Scheuer histological scoring system. HCV genotyping was performed for each patient by sequence analysis of the 5' non-coding region. The histological appearances from HCV 1 infected patients showed a tendency towards more active necroinflammatory changes when compared with those from HCV 2 or 3 infected patients. The levels of fibrosis were similar for all genotypes. The modified HA1 and Scheuer scoring systems detected differences, not revealed by the Knodell system, in the types of inflammatory pathology produced by the different genotypes of HCV. In particular these scoring systems noted significant differences in the component scores of inflammation, in addition to the total inflammatory scores. In conclusion, the recently introduced scoring systems were able to detect differences in liver pathology produced by infection of similar duration with different viral genotypes. As genotype is considered an important determinant of disease progression and response to anti-viral therapy, it is likely that those scoring systems correlating with genotype will yield more useful histological information than those that do not.

Portal cd4+ and cd8+ t lymphocyte correlate to intensity of interface hepatitis in chronic hepatitis C

“…The clinical significance of genotyping is still under investigation 3,11,28 , and in this study, unlike previous studies, there was no correlation between HVC genotypes and the CD4+ or CD8+ TL expression in the liver 32,34 , possibly because of the small number of genotypes 2 and 3 in this sample.…”

Kingʼs Score: an accurate marker of cirrhosis in chronic hepatitis C

“…King's Score: an accurate marker of cirrhosis in chronic hepatitis C Introduction Liver biopsy (LB) is considered the 'gold standard' for assessing the grade of necroinflammatory activity and stage of liver fibrosis in chronic hepatitis C. Historically, patients were considered to be candidates for combination therapy with peginterferon-a and ribavirin if they had moderate to severe disease, defined by histological evidence of significant fibrosis and/or inflammation [1,2]. Risks, however, associated with LB including pain, bleeding and death [3] are observed.…”