Liver biopsy is a useful predictor of response to interferon therapy in chronic hepatitis C

Authors


Dr Kaserer Department of Clinical Pathology, Unversity of Vienna, Allgemeines Krankenhaus, A-1090 Vienna, Währinger Gürtel 18–20, Austria.

Abstract

Aim

To evaluate the usefulness of easily assessable morphological parameters in liver biopsies in order to predict efficacy of interferon-α (IFN) treatment in patients with chronic hepatitis C.

Methods and results

Inflammatory activity and fibrosis (according to Scheuer), and the hepatic iron content (according to Rowe and DiBisceglie) were assessed in pre-treatment liver biopsies of 73 de novo patients with chronic hepatitis C. Furthermore the presence of fat, lymphoid aggregates, and bile duct lesions was evaluated. With respect to IFN therapy patients were classified as responders alanine aminotransferase (ALT) normal and negative hepatitis C virus (HCV) RNA in serum at the end of treatment, n = 33) or non-responders (n = 40). Non-responders had more advanced fibrosis (P = 0.0001) and more extensive iron storage (P = 0.0008) than responders. In contrast absence of stainable iron was frequently (46%) associated with sustained response. Absence of fat droplets in hepatocytes was associated with response (P = 0.0001). Stepwise logistic regression analysis indicated that the stage of fibrosis, the hepatic iron grade, and the presence or absence of fat were independent predictors of response.

Conclusions

Liver biopsy provides useful information for selection of patients with hepatitis C for IFN therapy.

Ancillary