Digestive Diseases and Sciences

, Volume 45, Issue 1, pp 182–187 | Cite as

Correlation of Genotypes and Route of Transmission with Histologic Activity and Disease Stage in Chronic Hepatitis C

  • Fernando Ramalho
  • Adília Costa
  • Antónia Pires
  • Paula Cabrita
  • Fátima Serejo
  • A. Pinto Correia
  • Narcisa Fatela
  • Helena Clória
  • Joäo Lopes
  • H. Cortez Pinto
  • Rui Marinho
  • Miguel Raimundo
  • José Velosa
  • Amélia Batista
  • M. Carneiro De Moura
Article

Abstract

Our objective was to evaluate the histopathological features of chronic hepatitis C of 64 liver biopsies and to correlate this with the route of transmission of hepatitis C virus, the genotype of HCV, and the patient's age. Moderate chronic hepatitis was the most frequently observed (62.5%). Cirrhosis was observed in 14 patients (21.9%) and was more frequently found among patients over 40 years of age (34.3% vs 6.9%, P = 0.025). The mean histopathological activity index (HAI) was significantly higher in the sporadic (10 ± 3.1) than the posttransfusional (7.5 ± 3.7) and the intravenous drug use (IVDU) groups (6.3 ± 2.8) (P < 0.02). Moreover the sporadic group showed more fibrosis (P < 0.04) than the posttransfusional group. No liver cirrhosis was found in the IVDU group. The overall prevalence of HCV variants was: 54.7% type 1b, 4.6% type 1a, 37.5% type 2c, 1.6% type 2b, 1.6% type 2. The genotype distribution showed no relation to the HAI, hepatitis activity (grade), and fibrosis (stage) of the liver disease. In conclusion, the sporadic route of transmission of HCV was related to a more severe chronic hepatic disease, a finding that could influence future antiviral therapies. The predominance of HCV type 1b in this study reflects the higher frequency of this variant in our area. Our data suggests that the ultimate consequence of HCV chronic infection depends on patient age rather than on HCV genotype.

chronic hepatitis C genotype hepatitis C virus transmission disease stage 

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REFERENCES

  1. 1.
    Choo QL, Kuo G, Werner A, et al: Isolation of a DNA clone derived from a blood-borne non-A, non-B viral hepatitis genome. Science 244:359-361, 1989PubMedGoogle Scholar
  2. 2.
    Kuo G, Choo QL, Alter HJ, et al: An assay for circulating antibodies to a major etiologic virus of human non-A, non-B hepatitis. Science 244:362-364, 1989PubMedGoogle Scholar
  3. 3.
    Sheuer PJ, Ashrafzadeh P, Sherlock S, Brown D, Dusheiko DM: The pathology of hepatitis C. Hepatology 15:567-571, 1992PubMedGoogle Scholar
  4. 4.
    Bach N, Thung SN, Schaffner F: The histological features of chronic hepatitis C: A comparative analysis. Hepatology 15:572-577, 1992PubMedGoogle Scholar
  5. 5.
    Lefkowitch JH, Schiff ER, Davis GL, et al: Pathologic diagnosis of hepatitis C: A multicenter comparative study with chronic hepatitis B. Gastroenterology 104:595-603, 1993PubMedGoogle Scholar
  6. 6.
    Jové J, Sanchez-Tapias M, Bruguera M, et al: posttransfusional vs sporadic non-A, non-B hepatitis: A clinicopathological and evolutive study. Liver 8:42-47, 1988PubMedGoogle Scholar
  7. 7.
    Rugge M, Vanstapel MJ, Ninfo V, et al: Comparative histology of acute hepatitis B and non-A, non-B in Leuven and Padova. Virchows Arch 401:275-278, 1983Google Scholar
  8. 8.
    Hopf U, Moller B, Kuther D, et al: Long term follow-up of post-transfusion and sporadic chronic hepatitis non-A, non-B and frequency of circulating antibodies to hepatitis C virus. J Hepatol 10:69-76, 1990PubMedGoogle Scholar
  9. 9.
    Gordon SC, Elloway RS, Long JC, Dmuchowski CF: The pathology of hepatitis C as a function of mode of transmission: Blood transfusion vs intravenous drug use. Hepatology 18:1338-1343, 1993PubMedGoogle Scholar
  10. 10.
    Delladetsima JK, Rassidakis G, Tassopoulos NC, Papatheodorides GV, Smyrnoff T, Vafiadis I: Histopathology of chronic hepatitis C in relation to epidemiological factors. J Hepatol 24:27-32, 1996PubMedGoogle Scholar
  11. 11.
    Simmonds P, Alberti A, Alter H, et al: Proposed system for the nomenclature of hepatitis C viral genotypes. Hepatology 19:1321-1324, 1994PubMedGoogle Scholar
  12. 12.
    Nousbaum J-B, Pol S, Nalpas B, Landais P, Bertholot P, Brechot C: Hepatitis C virus type 1b in France and Italy. Ann Intern Med 122:161-168, 1995PubMedGoogle Scholar
  13. 13.
    Silini EM, Bono F, Avidini A, et al: Differential distribution of hepatitis C virus genotypes in patients with and without liver function abnormalities. Hepatology 21:285-290, 1995PubMedGoogle Scholar
  14. 14.
    Pozatto G, Kaneko S, Moretti M, et al: Different genotypes of HCV are associated with different severity of chronic Liver disease. J Med Virol 43:291-296, 1994PubMedGoogle Scholar
  15. 15.
    Maharney K, Tedeschi V, Matterns G, DiBiscaglie AM, Vergalla J, Hoofnagle JH: Genotypic analysis of HCV in American patients. Hepatology 20:1405-1411, 1994PubMedGoogle Scholar
  16. 16.
    Yamada M, Kakumo S, Yoshioka K, et al: Hepatitis C virus genotypes are not responsible for development of serious liver disease. Dig Dis Sci 39:234-239, 1994PubMedGoogle Scholar
  17. 17.
    Ramalho F, Serejo F, Raimundo M, et al: Genotipos do virus da hepatite C-sua importância na forma de transmissão e na gravidade da doença hepática. GE J Port Gastroenterol 4:70-76, 1997Google Scholar
  18. 18.
    Knodell RG, Ishak KG, Black WC, et al: Formulation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis. Hepatology 1:431-435, 1981PubMedGoogle Scholar
  19. 19.
    Alter HJ, Margolis HS, Krawezynski K, et al: The natural history of community acquired hepatitis in the United States. N Engl J Med 327:1889-1905, 1992Google Scholar
  20. 20.
    Genesca J, Esteban JI, Alter H: Blood borne non-A, non-B hepatitis: Hepatitis C. Semin Liver Dis 11:147-164, 1991PubMedGoogle Scholar
  21. 21.
    Mattson L, Weilland O, Glaumann H: Chronic non-A, non-B hepatitis developed after transfusion, illicit self-injections or sporadically. Outcome during long-term follow-up. A comparison. Liver 9:120-127, 1989PubMedGoogle Scholar
  22. 22.
    Ramalho F, Raimundo M, Glória H, et al: História natural da hepatite Crónica C. Rev Intern 1:A47-A53, 1993Google Scholar
  23. 23.
    Ramalho F: História natural da Hépatiite C. In Hepatitesí viricas: bases cientificas e prática clnica. F. Carneiro Chaves (ed). Permanyer, Portugal. 1997, pp 109-114Google Scholar
  24. 24.
    Titó L, Sanchez JM, Costa J, et al: Long term follow-up of chronic C hepatitis. J Hepatol 11:S61, 1990Google Scholar
  25. 25.
    Koretz RL, Abbey H, Loleman E, Gitnick G: Non-A, non-B post-transfusion hepatitis. Looking back in the second decade. Ann Intern Med 119:110-115, 1993PubMedGoogle Scholar
  26. 26.
    Takahashi M, Yamada G, Miyamoto R, Doi T, Endo H, Tsuji T: Natural course of chronic hepatitis C. Am J Gastroenterol 88:240-243, 1993PubMedGoogle Scholar
  27. 27.
    Muller R: The natural history of hepatitis C: Clinical experiences. J Hepatol 24:52-54, 1996Google Scholar
  28. 28.
    Lucidarme D, Foutrein P, Creusy C, et al: Prevalence des marquers des hepatitis C, B et D et aspects histopathologiques dans un group de toxicomanes intraveineux. Gastroenterol Clin Biol 18:964-968, 1994PubMedGoogle Scholar
  29. 29.
    Wantzin P, Krogsgaard K, Kryger P, et al: Detection of antibody to hepatitis C virus in 130 patients with acute non-A, non-B hepatitis. In Proceedings of the International Symposium in viral hepatitis and liver disease. Houston, 1990, p 154Google Scholar
  30. 30.
    Kim-Deobald J, Banermeister D, Bredfelt J, et al: The histologic progression of mild chronic hepatitis C. Gastroenterology 104:A927, 1993Google Scholar
  31. 31.
    Lau JYN, Davis GL, Kuiffen J, et al: Significance of serum hepatitis C virus RNA levels in chronic hepatitis C. Lancet 341:1501-1504, 1993PubMedGoogle Scholar
  32. 32.
    Nelson DR, Marousis CG, Davis GL, Rice CM, Wong J, Houghton M, Lau JYN: The role of hepatitis C virus-specific cytotoxic T lymphocytes in chronic hepatitis C. J Immunol 158:1473-1481, 1997PubMedGoogle Scholar
  33. 33.
    Fattovich G: Natural course and prognosis of chronic hepatitis type B. Viral Hepatitis Rev 2:263-276, 1996Google Scholar
  34. 34.
    Honda M, Kaneko S, Sakkai A, et al: Degree of diversity of hepatitis C virus quasi-species and progression of liver disease. Hepatology 20:1144-1145, 1994PubMedGoogle Scholar
  35. 35.
    Natto M, Hayashi N, Moribe T, et al: Hepatitis C virus quasi-species in hepatitis C virus carriers with normal liver enzymes and patients with type C chronic liver disease. Hepatology 22:407-412, 1995PubMedGoogle Scholar
  36. 36.
    Simmonds P, Mellor J, Craxi A, et al: Epidemiological, clinical and therapeutic association of hepatitis C virus types in western European countries. J Hepatol 24:517-524, 1996PubMedGoogle Scholar
  37. 37.
    Dusheiko G, Schmilovitz-Weiss H, Brown D, et al: Hepatitis C virus genotypes: An investigation of type-specific differences in geographic origin and disease. Hepatology 19:13-18, 1994PubMedGoogle Scholar
  38. 38.
    Marigia A, Cascavilla I, Lezzi G, et al: HCV genotypes in patients with liver diseases of different stages and severity. J Hepatol 26:1173-1178, 1997PubMedGoogle Scholar
  39. 39.
    López-Labradore FX, Ampurdanés S, Forus X, et al: Hepatitis C virus genotypes in Spanish patients with HCV infection: Relationship between HCV genotype 1b, cirrhosis and hepatocellular carcinoma. J Hepatol 27:959-965, 1997PubMedGoogle Scholar
  40. 40.
    Sillini E, Botelli R, Asti M, et al: Hepatitis C virus genotypes and risk of hepatocellular carcinoma in cirrhosis: A case-control study. Gastroenterology 111:199-205, 1996PubMedGoogle Scholar
  41. 41.
    Millin S, Fayyazi A, Hartmann H, Romadori G: Analysis of histopathological manifestations of chronic hepatitis C virus infection with respect to virus genotype. Hepatology 25:735-739, 1997PubMedGoogle Scholar
  42. 42.
    Benvegni L, Pontisso P, Cavaletto D, Noventa F, Chemello L, Alberti A: Lack of correlation between hepatitis C virus genotypes and clinical course of hepatitis C virus-related cirrhosis. Hepatology 25:211-215, 1997PubMedGoogle Scholar
  43. 43.
    Qu D, Li JS, Vitvitski L, et al: Hepatitis C virus genotypes in France: Comparison of clinical features of patients infected with HCV type I and type II. J Hepatol 21:70-75, 1994PubMedGoogle Scholar

Copyright information

© Plenum Publishing Corporation 2000

Authors and Affiliations

  • Fernando Ramalho
    • 1
  • Adília Costa
    • 1
  • Antónia Pires
    • 1
  • Paula Cabrita
    • 1
  • Fátima Serejo
    • 1
  • A. Pinto Correia
    • 1
  • Narcisa Fatela
    • 1
  • Helena Clória
    • 1
  • Joäo Lopes
    • 1
  • H. Cortez Pinto
    • 1
  • Rui Marinho
    • 1
  • Miguel Raimundo
    • 1
  • José Velosa
    • 1
  • Amélia Batista
    • 1
  • M. Carneiro De Moura
    • 1
  1. 1.Liver Unit and Pathology DepartmentHospital de Santa MariaLisbonPortugal

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