CHRONIC HEPATITIS IN PATIENTS WITH ACTIVE HEPATITIS-B VIRUS AND HEPATITIS-C VIRUS COMBINED INFECTIONS - A HISTOLOGICAL STUDY

Objectives: To evaluate whether peculiar histological changes are pres ent in liver tissue of patients with chronic hepatitis by hepatitis B and hepatitis C (HBV and HCV) virus combined infections. Methods: We s tudied liver biopsy specimens from 14 HE surface antigen/anti-HCV-posi tive patients consecutively admitted to hospital because of chronic li ver disease from 1987 to 1992. Alcohol abusers, drug addicts, hepatiti s 6 virus- and HIV-infected subjects were excluded from the study. Ah of them were positive for serum HBV-DNA and/or intrahepatic HE core an tigen and for serum HCV-RNA. Histological examination showed mild or m oderate chronic hepatitis in nine cases and severe chronic hepatitis w ith cirrhosis in five cases. Two additional sets of liver biopsy speci mens were also included in the study, consisting of liver samples from 14 patients with chronic liver disease due to active HBV infection al one (group B) and from 14 patients with active HCV infection alone (gr oup C). Cases from group B and C matched for age, sex, and histologica l diagnosis with those from group B + C. Histological patterns of all the liver specimens of the three groups were re-examined by two author s who scored the found features using a scale from 0 to 3. Results: No peculiar histological pattern was revealed in group B + C, and most o f the detected microscopic features were similarly present in all thre e groups. Bile duct lesions and well defined lymphoid follicles were f ound only in liver samples of patients from groups C and B + C. Ground -glass hepatocytes were observed only in cases from the groups B and B + C. Conclusions: Histological examination of liver tissue from patie nts with chronic HBV and HCV combined infection does not show either t ypical patterns or evidence that this subgroup of chronic viral hepati tis is a more severe form of liver disease than that caused by a singl e virus infection. The observation in liver samples of peculiar lesion s by HBV or HCV infection does not exclude a combined infection by bot h viruses.