Steatosis and bile duct damage in chronic hepatitis C: distribution and relationships in a group of Northern Italian patients

: Background/Aims: Hepatitis C virus (HCV) related disease follows a long, benign course and most affected patients have mild disease. Liver biopsy is mandatory to grade and stage the disease. Characteristic, though non‐specific, HCV histological lesions such as bile duct damage and steatosis have b...

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Bibliographic Details
Published in:Liver (Copenhagen) 1999-10, Vol.19 (5), p.432-437
Main Authors: Giannini, Edoardo, Ceppa, Paola, Botta, Federica, Fasoli, Alberto, Romagnoli, Paola, Cresta, Elena, Venturino, Valentina, Risso, Domenico, Celie, Guido, Testa, Roberto
Format: Article
Language:English
Subjects:
Adult
Alkaline Phosphatase - blood
Analysis. Health state
Aspartate Aminotransferases - blood
bile duct damage
Bile Duct Diseases - blood
Bile Duct Diseases - epidemiology
Bile Duct Diseases - etiology
Bile Duct Diseases - pathology
Bile Ducts - pathology
Bilirubin - blood
Biological and medical sciences
Epidemiology
Fatty Liver - blood
Fatty Liver - epidemiology
Fatty Liver - etiology
Fatty Liver - pathology
Female
gamma-Glutamyltransferase - blood
General aspects
Genotype
Hepacivirus - classification
Hepacivirus - genetics
Hepacivirus - immunology
Hepatitis C
Hepatitis C Antibodies - blood
Hepatitis C, Chronic - blood
Hepatitis C, Chronic - complications
Hepatitis C, Chronic - epidemiology
Hepatitis C, Chronic - pathology
histology
Humans
Italy - epidemiology
Male
Medical sciences
Middle Aged
Public health. Hygiene
Public health. Hygiene-occupational medicine
Reverse Transcriptase Polymerase Chain Reaction
RNA, Viral - blood
Sex Distribution
steatosis
viral genotypes
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Summary:: Background/Aims: Hepatitis C virus (HCV) related disease follows a long, benign course and most affected patients have mild disease. Liver biopsy is mandatory to grade and stage the disease. Characteristic, though non‐specific, HCV histological lesions such as bile duct damage and steatosis have been singled out but their association with non‐histological parameters has not been completely defined. Our aim was to study the relationships among these histological lesions and clinical, biochemical, functional and virological characteristics in a group of Northern Italian patients with chronic hepatitis. Methods: We studied 172 patients with HCV‐related chronic hepatitis. Patients were divided into groups on the basis of histology including bile duct damage and steatosis. Clinical, biochemical, functional and virological profiles were related to histological findings. Results: Histological grading and staging of disease increased as the age of patients increased. Steatosis was present in 70% of our patients and was related to a higher degree of fibrosis and to decreased functional activity. The prevalence of bile duct damage was 20%. This lesion was present in older patients with higher staging and impaired liver function. Biochemically it was associated with an increase in aspartate aminotransferase, gammaglutamyltranspeptidase, alkaline phosphatase, and total bilirubin. Conclusions: In the population we studied, HCV chronic hepatitis was predominantly a mild disease. Moreover both steatosis and bile duct damage were also mild. Steatosis was associated with fibrosis and this might influence liver metabolic function. Bile duct lesions were found in older patients with advanced disease showing biochemical evidence of cholestasis. The molecular role HCV might play in the pathogenesis of these histological features should be addressed in further studies.
ISSN:0106-9543
1600-0676
DOI:10.1111/j.1478-3231.1999.tb00074.x