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.
Similar content being viewed by others
REFERENCES
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, 1989
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, 1989
Sheuer PJ, Ashrafzadeh P, Sherlock S, Brown D, Dusheiko DM: The pathology of hepatitis C. Hepatology 15:567-571, 1992
Bach N, Thung SN, Schaffner F: The histological features of chronic hepatitis C: A comparative analysis. Hepatology 15:572-577, 1992
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, 1993
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, 1988
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, 1983
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, 1990
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, 1993
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, 1996
Simmonds P, Alberti A, Alter H, et al: Proposed system for the nomenclature of hepatitis C viral genotypes. Hepatology 19:1321-1324, 1994
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, 1995
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, 1995
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, 1994
Maharney K, Tedeschi V, Matterns G, DiBiscaglie AM, Vergalla J, Hoofnagle JH: Genotypic analysis of HCV in American patients. Hepatology 20:1405-1411, 1994
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, 1994
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, 1997
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, 1981
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, 1992
Genesca J, Esteban JI, Alter H: Blood borne non-A, non-B hepatitis: Hepatitis C. Semin Liver Dis 11:147-164, 1991
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, 1989
Ramalho F, Raimundo M, Glória H, et al: História natural da hepatite Crónica C. Rev Intern 1:A47-A53, 1993
Ramalho F: História natural da Hépatiite C. In Hepatitesí viricas: bases cientificas e prática clnica. F. Carneiro Chaves (ed). Permanyer, Portugal. 1997, pp 109-114
Titó L, Sanchez JM, Costa J, et al: Long term follow-up of chronic C hepatitis. J Hepatol 11:S61, 1990
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, 1993
Takahashi M, Yamada G, Miyamoto R, Doi T, Endo H, Tsuji T: Natural course of chronic hepatitis C. Am J Gastroenterol 88:240-243, 1993
Muller R: The natural history of hepatitis C: Clinical experiences. J Hepatol 24:52-54, 1996
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, 1994
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 154
Kim-Deobald J, Banermeister D, Bredfelt J, et al: The histologic progression of mild chronic hepatitis C. Gastroenterology 104:A927, 1993
Lau JYN, Davis GL, Kuiffen J, et al: Significance of serum hepatitis C virus RNA levels in chronic hepatitis C. Lancet 341:1501-1504, 1993
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, 1997
Fattovich G: Natural course and prognosis of chronic hepatitis type B. Viral Hepatitis Rev 2:263-276, 1996
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, 1994
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, 1995
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, 1996
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, 1994
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, 1997
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, 1997
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, 1996
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, 1997
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, 1997
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, 1994
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ramalho, F., Costa, A., Pires, A. et al. Correlation of Genotypes and Route of Transmission with Histologic Activity and Disease Stage in Chronic Hepatitis C. Dig Dis Sci 45, 182–187 (2000). https://doi.org/10.1023/A:1005442317680
Issue Date:
DOI: https://doi.org/10.1023/A:1005442317680