Journal of Gastroenterology

, Volume 31, Issue 1, pp 69–74

Assessment of histological features and outcome of interferon therapy in chronic hepatitis C

  • Naoki Kumagai
  • Shigeru Kuramochi
  • Kyouko Toda
  • Naoto Iwabuchi
  • Kanji Tsuchimoto
  • Satoshi Tsunematsu
  • Hidetsugu Saito
  • Toshio Morizane
  • Masaharu Tsuchiya
  • Hiromasa Ishii
Article

Abstract

The correlation between the histological features of liver biopsy specimens before interferon (IFN) treatment and the clinical effect of IFN administration on chronic hepatitis C was investigated. A study of the relation between several histological features that were graded in 60 liver biopsy specimens from chronic hepatitis C patients before IFN treatment disclosed that the grade of portal fibrosis was positively correlated with the grade of other inflammatory features, including piecemeal necrosis and portal and lobular inflammation. The degree of portal fibrosis adversely affected the rate of normalization of ALT levels in chronic hepatitis C during and after IFN treatment. We reexamined 36 liver biopsy specimens that showed a moderate degree of portal fibrosis, and found that the degree of piecemeal necrosis was inversely correlated with the extent of lymphoid follicle formation in the portal tracts. During IFN therapy, the group of chronic hepatitis C patients who showed marked piecemeal necrosis and less lymphoid follicle formation in the liver specimens had a poor response to IFN treatment, whereas another group that showed marked lymphoid follicle formation and little piece-meal necrosis in the liver specimens had a good response to IFN. These relationships gradually disappeared after the completion of IFN treatment.

Key words

hepatitis C interferon therapy liver histology 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Choo Q-L, Kuo G, Weiner AJ, et al. Isolation of a cDNA clone derived from a blood-borne non-A, non-B viral hepatitis genome. Science 1989;244:359–362.PubMedGoogle Scholar
  2. 2.
    Devis GL, Balart LA, Schiff ER, et al. Treatment of chronic hepatitis C with recombinant interferon alfa. N Engl J Med 1989;321:1506–1511.PubMedGoogle Scholar
  3. 3.
    Di Bisceglie AM, Martin P, Kassianides C, et al. Recombinant interferon alfa therapy for chronic hepatitis C. N Engl J Med 1989;321:1506–1511.PubMedGoogle Scholar
  4. 4.
    Shindo M, Di Biseglie AM, Hoofnagel JH. Long-term follow-up of patients with chronic hepatitis C treated with α-interferon. Hepatology 1992;15:1013–1016.PubMedGoogle Scholar
  5. 5.
    Devis GL, Hepatitis C virus antibody in patients with chronic autoimmune hepatitis: Pitfalls in diagnosis and implication for treatment. Mayo Clin Proc 1991;66:647–650.PubMedGoogle Scholar
  6. 6.
    Michel G, Ritter A, Gerken G, et al. Anti-GOR and hepatitis C virus in autoimmune liver diseases. Lancet 1992;339:267–269.PubMedGoogle Scholar
  7. 7.
    Vento S, Perri G, Garofano T. Hazards of interferon therapy for HBV-seronegative chronic hepatitis. Lancet 1989;II:926.Google Scholar
  8. 8.
    Popper H, Dienstag JL, Feinstone SM, et al. Pathology of viral hepatitis in chimpanzees. Virchows Arch [A] 1980;387:91–106.Google Scholar
  9. 9.
    Thung SN, Gerber MA, Popper H. Basic morphologic patterns of viral hepatitis A,B, non-A, non-B, and delta agent in animal and man. In: Chisari FV (ed) Advances in hepatitis research. New York: Masson, 1984;293–302.Google Scholar
  10. 10.
    Gerber MA, Thung SN, Viral hepatitis: Pathology. In: Berk JE, Haubrich WS, Kalser MH, Roth JLA, Schaffner F (eds) Bockus gastroenterology. 4th ed. Vol. V: The liver. Philadelphia: W.B. Saunders, 1985:2825–2855.Google Scholar
  11. 11.
    Texeria MR Jr, Weller IVD, Murray A, et al. The pathology of hepatitis A in man. Liver 1982;2:53–60.PubMedGoogle Scholar
  12. 12.
    Mosnier JF, Degott C, Marcellin P, et al. The intraportal lymphoid nodule and its environment in chronic active hepatitis C: An immunohistochemical study. Hepatology 1993;17:366–371.PubMedGoogle Scholar
  13. 13.
    Soga M, Yamasaki H, Tomita A, et al. Successful treatment with interferon for a HCV-RNA positive patients with features of “autoimmune hepatitis” (Abstract in English). Acta Hepatol Jap 1992;38:548–551.Google Scholar
  14. 14.
    Bach N, Thung SN, Schaffner F. The histological features of chronic hepatitis C and autoimmune chronic hepatitis: A comparative analysis. Hepatology 1992;15:572–577.PubMedGoogle Scholar
  15. 15.
    Garson JA, Tedder RS, Briggs M, et al. Detection of hepatitis C viral sequences in blood donations by “nested” polymerase chain reaction and prediction of infectivity. Lancet 1990;335:1419–1422.PubMedGoogle Scholar
  16. 16.
    Hagiwara H, Hayashi N, Mita E, et al. Detection of hepatitis C virus RNA in serum of patients with chronic hepatitis C treated with interferon-α. Hepatology 1992;15:37–41.PubMedGoogle Scholar
  17. 17.
    Dienes HP, Popper H, Arnold W, et al. Histologie observation in human hepatitis non-A, non-B. Hepatology 1982;2:562–571.PubMedGoogle Scholar
  18. 18.
    Scheuer PS, Ashrafzadeh P, Sherlock S, et al. The pathology of hepatitis C. Hepatology 1992;15:567–571.PubMedGoogle Scholar
  19. 19.
    Roberts JM, Serie JW, Cooksley WGE. Histological patterns of prolonged hepatitis C infection. Gastroenterol Jpn 1993;28:37–41.PubMedGoogle Scholar
  20. 20.
    Gerber MA. Pathology of hepatitis C. FEMS Microbiol Rev 1994;14:205–210.PubMedGoogle Scholar
  21. 21.
    Uchida T. Pathology of hepatitis C. Intervirology 1994;37:126–132.PubMedGoogle Scholar
  22. 22.
    Lefkowitch JH, Schiff ER, Davis GL, et al. Pathological diagnosis of chronic hepatitis C: A multicenter comparative study with chronic hepatitis B. Gastroenterology 1993;104:595–603.PubMedGoogle Scholar
  23. 23.
    Yoshida H, Iwabuchi S, Murayama M, et al. Histological evaluation of the liver and response to interferon in chronic hepatitis C. Nippon Rinsho 1994;52:1763–1768.PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • Naoki Kumagai
    • 1
  • Shigeru Kuramochi
    • 3
  • Kyouko Toda
    • 2
  • Naoto Iwabuchi
  • Kanji Tsuchimoto
  • Satoshi Tsunematsu
  • Hidetsugu Saito
  • Toshio Morizane
  • Masaharu Tsuchiya
  • Hiromasa Ishii
    • 4
  1. 1.Department of Internal MedicineKitasato Institute HospitalTokyoJapan
  2. 2.Department of Biomedical LaboratoryKitasato Institute HospitalTokyoJapan
  3. 3.Department of Pathology, School of MedicineKeio UniversityTokyoJapan
  4. 4.Department of Internal Medicine, School of MedicineKeio UniversityTokyoJapan

Personalised recommendations