The present study aimed to analyze the pathology of chronic hepatitis
C in relation to HCV serotype, and to speculate on possible difference
s in the pathogenesis of liver injury. Liver biopsies were investigate
d from 59 consecutive patients in whom hepatitis C virus genotypes wer
e determined by a serological genotyping assay that detects antibodies
directed to epitopes encoded by the NS4 region. A morphological study
was performed in each case, semiquantitatively scoring necro-inflamma
tory and fibrotic liver lesions. The prevalence of HCV serotypes was a
s follows: 26 of the 59 patients (44%) had type 1 infection, 11 (19%)
had type 2 and 20 (35%) had type 3. A significant association between
intravenous drug abuse and serotype 3 infection was observed. Patients
with HCV type 2 proved significantly older than patients with infecti
on types 1 or 3, and more frequently they showed a more active liver d
isease, but no differences were found in the quality and acinar topogr
aphic distribution of all the morphological lesions scored. In conclus
ion, in chronic hepatitis C a more active liver disease can be related
to HCV serotype 2 but the spectrum of liver lesions is independent of
HCV types. From a morphological point of view, a different pathogenes
is of liver injury related to different HCV types is unlikely.