Correlation of Histological Severity between Genotype 3 and Others in HCV Chronic Hepatitis

Abstract

Purpose: Genome heterogeneity may be related to the wide variability of clinical and pathological features in hepatitis C virus (HCV) related chronic liver disease. The aim of this study is to see the significance of hepatitis C genotypes in relation to the severity of liver disease and to determine if the histological activity index (HAI) and fibrosis are more severe in genotype 3 than others. Methods: Fifty-one consecutive liver biopsies of naïve patients with hepatitis C were evaluated. Serologic HCV-RNA was verified by RT-PCR and genotyping by direct sequencing. Grading of necroinflammatory and staging of fibrosis were hisologically assessed by Metavir scoring system. The disease activity was graded as minimal (A1), moderate (A2) and severe (A3). The extent of fibrosis was marked as absent (F0), mild (F1), moderate (F2) and severe (F3). Results were analyzed using t-test. Results: 28/51 (51%) were genotype 3 almost all from South Asia and 23/51 (45%) were non-genotype 3 from a mixed ethnic group mostly native born Americans. There were 23/51 (45%) males and 28/51 (55%) females. The mean age of the patients were 45.1 (age range of 26–65). There were 14/28 (50%) males and 14/28 (50%) females in genotype 3 with a mean age of 41. There were 9/23 (39%) males and 14/23 (61%) females in non-genotype 3 with a mean age of 49.2. The mean activity score was 1.178 in genotype 3 and 1.434 in non-genotype 3 (p 0.085). The mean fibrosis score was 1.964 in genotype 3 and 2.000 in non-genotype 3 with a (p 0.46) Conclusions: There was no statistically significant difference between histological activity and fibrosis between genotype 3 and others. Genotype 3 is histologically similar to other genotypes in severity. Genotype is not useful in predicting the severity of hepatitis C related liver disease.