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Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Apr 28, 2008; 14(16): 2522-2528
Published online Apr 28, 2008. doi: 10.3748/wjg.14.2522
Prognostic factors for progression of liver structural lesions in chronic hepatitis C patients
Liliana SC Mendes, Marcelo E Nita, Suzane K Ono-Nita, Evandro S Mello, Luiz Caetano da Silva, Venâncio AF Alves, Flair J Carrilho
Liliana SC Mendes, Marcelo E Nita, Suzane K Ono-Nita, Luiz Caetano da Silva, Flair J Carrilho, Department of Gastroenterology-Hepatology Branch, University of São Paulo School of Medicine, São Paulo, 04537-040 São Paulo-SP, Brazil
Evandro S Mello, Venâncio AF Alves, Department of Pathology, University of São Paulo School of Medicine, São Paulo, 04537-040 São Paulo-SP, Brazil
Correspondence to: Flair J Carrilho, Department of Gastroenterology, University of São Paulo School of Medicine, R. Silva Correia, 153, ap 41, 04537-040 São Paulo-SP, Brazil. fjcarril@usp.br
Telephone: +55-11-30697830
Fax: +55-11-30697830
Received: September 14, 2007
Revised: February 26, 2008
Published online: April 28, 2008
Abstract

AIM: To evaluate the epidemiological, clinical, laboratory and histological variables capable of predicting the progression of hepatic structural disturbances in chronic hepatitis C patients during the time interval between two liver biopsies.

METHODS: Clinical charts of 112 chronic hepatitis C patients were retrospectively analyzed, whereas liver biopsies were revised. Immunohistochemical detection of interferon receptor was based on the Envision-Peroxidase System.

RESULTS: In the multivariate analysis, the variables in the age at first biopsy, ALT levels, presence of lymphoid aggregates and siderosis were the determinants of the best model for predicting the severity of the disease. The direct progression rate of hepatic structural lesions was significantly higher in untreated patients, intermediate in treated non-responders and lower in treated responders to antiviral therapy (non-treated vs responders, 0.22 ± 0.50 vs -0.15 ± 0.46, P = 0.0053). Immuno-expression of interferon receptor is not a relevant factor.

CONCLUSION: The best predictors of the progression of fibrosis are age at the first liver biopsy, extent of ALT elevation, inflammation at liver histology and hepatic siderosis. Antiviral treatment is effective in preventing the progression of liver structural lesions in chronic hepatitis C patients.

Keywords: Hepatitis C; Histology; Fibrosis; Interferons; Disease progression