Non-Invasive Assessment of Inflammatory Activity and Fibrosis (Grade and Stage) in Chronic Hepatitis C Infection

Abstract

Background: Much effort has been expended in finding non-invasive alternatives to percutaneous liver biopsy for assessing the histological extent of liver damage. Methods: We have evaluated the relationship between various histological features of liver biopsies and plasma levels of immunoglobulin G (IgG), procollagen III propeptide (PIIIP) and type-IV collagen (CL-IV) in 109 patients with chronic hepatitis C (HCV) infection. Results: The serum IgG level was the best single marker for distinguishing chronic persistent hepatitis (CPH) from chronic active hepatitis (CAH). The mean serum levels ot'PIIIP and CL-IV increased with the progression of liver disease, though the three variables manifested considerable overlap in individual values as markers of CPH, CAH and cirrhosis. The various biochemical markers correlated weakly but significantly to both histological grade and stage of liver disease, as assessed with the scoring system of Knodell. The correlation appeared to be non-specific and to reflect inflammatory activity as well as fibrogenesis. Conclusions: Serum levels of PI1IP, CL-IV and IgG are of limited use in predicting the histological grade and stage of liver disease in patients with chronic HCV infection.