Background/Aims: To evaluate the clinicopathological features of chronic
hepatitis C, 170 liver biopsies were studied and histological grade and
stage (degree of fibrosis) of hepatitis were correlated with
epidemiological features and characteristic histological findings.
Methods/Results: Normal liver was found in 3 (1.8%), minimal chronic
hepatitis in 40 (23.5%), mild chronic hepatitis in 104 (61.2%) and
moderate chronic hepatitis in 23 (13.5%) cases. Cirrhosis was observed
in 24 (14.1%) patients and was more frequently encountered among
patients more than 40 years old (34.4% vs 2.8%, p<10(-6)) and rarely
among intravenous drug users in comparison with post-transfusion and
sporadic cases (3% vs 25% and 20% respectively, p<0.005). Minimal
chronic hepatitis was more frequently observed among patients 40 years
old or younger (30.3% vs 11.5%, p<0.01)), while moderate chronic
hepatitis was significantly more common in older age groups (24.6% vs
7.3%, p<0.005). Multiple regression analysis revealed that only age was
statistically related to histological grade and stage of hepatitis
(p<10(-5)). The frequency of the histological features more likely seen
in chronic hepatitis C, including steatosis (57.6%), lymphoid follicles
and/or aggregates (F/A) (47.1%) and bile duct lesions (22.9%),
increased with hepatitis grade and the latter two features were more
often encountered in moderate chronic hepatitis (p<0.005); in addition,
both lesions statistically coexisted (p<0.005). No correlation was found
between histological findings and possible source of infection.
Conclusions: More than half of the chronic hepatitis C patients
presented mild histological lesions. Age was proven to be the only
independent epidemiological factor related to histological grade and
stage of hepatitis. Lymphoid F/A and bile duct damage are important
diagnostic findings associated with hepatitis activity