CLINICAL AND HISTOLOGICAL ASPECTS OF CHRONIC HCV INFECTION AND CIRRHOSIS

We studied 608 consecutive cases of anti-HCV-positive chronic liver di sease. In 358 patients the diagnosis was established by needle liver b iopsy. In 250 patients with liver cirrhosis the diagnosis was made on the basis of the unequivocal clinical signs and the results of imaging procedures. Chronic HCV infection is usually observed in adults or el derly patients; the age of the patients steadily increases with the pr ogression of the illness to the more severe stages. Jaundice was infre quent in patients with chronic hepatitis or early cirrhosis; clinical symptoms and laboratory tests are of little value in differentiating C PH from CAH or in detecting early cirrhosis. Serum aminotransferases w ere usually only slightly elevated in all stages of the disease. Despi te the mildness of the hepatic cytolysis, the progressive reduction in serum cholinesterase and albumin concentrations and the progressive i ncrease in the serum alkaline phosphatase activity indicate progressiv e failure in the hepatic function in the course of the illness. The hi stological study showed that steatosis, follicular portal inflammation and eosinophilic changes in the hepatocytes were prominent features o f chronic HCV infection. In contrast, severe piecemeal necrosis withou t bridging was rarely observed.