BACKGROUND:
The aim of the study was to analyse the morphology, clinical presentation and
predisposing factors for
chronic hepatitis C infection.
METHODS:
Clinical presentation of 220
patients who presented with
hepatitis C virus infection over five years period (January 1996 to December 2000) were recorded.
Liver biopsy specimens from 80
adult patients with
chronic hepatitis C virus were evaluated using a semiquantitative scoring system. The possible predisposing
risk factors for
infection in these
patients were recorded.
RESULTS:
Grading of
chronic hepatitis C was minimal/mild in 51 (64%) cases. Seven (8.7%) had high-grade necroinflammatory activity.
Fibrosis was absent in 22(27.5%), mild in 29(36.25%), moderate in 11 (13.75%) and 18(22.5%) had evidence of
cirrhosis. No significant correlation was found between the level of
transaminases and degree of
fibrosis or grade of
inflammation. More number of
patients with
history of
alcohol consumption had moderate/severe grade of necroinflammatory activity and
cirrhosis as compared to those not taking alcohol at all. Potential
predisposing factors were use of unsterile
syringes, previous
surgery and
tattooing in
multivariate analysis.
CONCLUSION:
Nearly two-thirds of
patients of
chronic hepatitis C where
liver biopsy was possible have minimal/mild
disease at
time of
diagnosis; 22% have
cirrhosis. Though
disease severity can only be assessed by
liver histology,
liver biopsy may not be possible in a sizeable proportion of
patients as they present with advanced
liver disease. Most of the
patients do not have specific symptoms. Reusable
needles/
syringes is the commonest potential
risk factor.