Chronic hepatitis C: hepatic fibrosis evolution after ineffective specific treatment

Specific treatment of chronic hepatitis C is effective in 50% of patients, improving the liver's fibrosis, necroinflammatory changes and steatosis. However, in patients still viremic after treatment the extension of these benefits remains doubtful. The evolution of the disease in this group and...

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Bibliographic Details
Published in:	Hepato-gastroenterology Vol. 55; no. 82-83; p. 657
Main Authors:	Widman, Azzo, Mendes-Corrêa, Maria Cássia Jacyntho, Zanoto, Arnaldo, Capacci, Maria de Lourdes, de Mello, Evandro Sobroza, Saad, Willian Abrão, Barone, Antonio Alci, Gama-Rodrigues, Joaquim José
Format:	Journal Article
Language:	English
Published:	Greece 01-03-2008
Subjects:	Adult Biopsy Female Hepatitis C, Chronic - complications Hepatitis C, Chronic - drug therapy Hepatitis C, Chronic - pathology Humans Liver Cirrhosis - etiology Liver Cirrhosis - pathology Male Middle Aged Treatment Failure
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Summary:	Specific treatment of chronic hepatitis C is effective in 50% of patients, improving the liver's fibrosis, necroinflammatory changes and steatosis. However, in patients still viremic after treatment the extension of these benefits remains doubtful. The evolution of the disease in this group and its relationship to demographic data, biometric indices and time lapse between biopsies was evaluated. In 141 patients, paired biopsies were classified and compared according to fibrosis grading. Necroinflammation, steatosis, demographic data (age and gender), body mass index (BMI) and time lapse between biopsies were compared with fibrosis grading. The grade of fibrosis of the patients, after approximately 3.5 years time lapse between biopsies, could be classified into 4 groups; Improved: 29 (20.0%), Unaltered: 64 (45.0%), Worsened: 48 (34%) and Cirrhotic: 14 (9.93%). For necroinflammation, the Improved/Unaltered groups were statistically similar but different from the Worsened and Cirrhotic. The mean age, BMI and time lapse between biopsies were statistically similar in all groups. Steatosis occurred in 35 (24.82%) between biopsies and its incidence was reduced in the Worsened and Cirrhotic groups. Fibrosis turned into cirrhosis in a significant number of patients, after a short time lapse. The reverse correlation of steatosis to fibrosis and its occurrence during the time lapse between biopsies suggests it might induce hepatic necrosis and contribute to fibrogenesis.
ISSN:	0172-6390