ENDOTHELIITIS-LIKE CHANGES IN CHRONIC HEPATITIS-C

Liver biopsies in hepatitis C frequently show bile duct damage, lympho id follicles, large and small droplet Eat, hepatocyte multinucleation. Mallory body-like material, and activation of sinusoidal inflammatory cells. Even though these lesions are useful parameters in the diagnos is of hepatitis C, their specificity remains uncertain. Endotheliitis- like changes of small portal veins have been described for various Liv er diseases, including viral hepatitis. The aim of the present study w as to investigate the prevalence and severity of endotheliitis-like ch anges in chronic hepatitis C in comparison with chronic hepatitis B. F or this purpose, liver biopsies of 50 patients with chronic hepatitis C and 48 patients which chronic hepatitis B were systematically analyz ed for the presence of endotheliitis-like changes. Endotheliitis-like changes were defined as lymphocytic infiltration of venous walls, sube ndothelial lymphocyte accumulation, adherence of lymphocytes to the en dothelium, and endothelial cell damage. Endotheliitis-like change seve rity was graded (borderline/questionable; slight to moderate; severe), and endotheliitis-like changes were analyzed in small portal veins an d in central veins. Endotheliitis-like changes were significantly more frequent in chronic hepatitis C than in chronic hepatitis B (41.5% vs . 6.9%; p<0.05). In chronic hepatitis C, endotheliitis-like changes pr edominated in small portal veins, but 27% of small hepatic veins were involved as well. The findings indicate that endotheliitis-like change s may represent a useful histological parameter in the diagnosis of ch ronic hepatitis C.