Histologic distribution of hepatitis A, B, C, D, E, and G with concomitantcytokine response in liver tissue

The purpose of this study was to determine the frequency of infection by he patitis A, B, C, D, E, and G in liver biopsy specimens from symptomatic pat ients and to correlate viral localization with the expression of interferon 7, interleukin 4, and tumor necrosis factor messenger RNA. Tissue biopsy s pecimens were taken from 78 patients as follows: 14 patients with transplan ts, 23 patients with cirrhotic livers, and 41 patients with chronic hepatit is. At least one of the hepatitis viruses was detected in 60 of 78 (77%) sp ecimens; multiple infection was evident in 18 of 78 (23%) specimens. The ov erall incidence of the different viruses was as follows: 8% hepatitis A, 3% hepatitis B, 52% hepatitis C, 1% hepatitis D, 24% hepatitis E, 18% hepatit is G. Throughout each category, hepatitis C was the most common virus detec ted. No histologic variable correlated with either the percentage of infect ed hepatocytes per lobule or nodule or with the specific viral type. The cy tokines localized to monocytes or lymphocytes adjacent to infected hepatocy tes. These results demonstrate that viral infection is present in most biop sy specimens of patients with chronic hepatitis and liver transplants and t hat hepatitis C, E, and G account for most of the infections. The results a lso suggest that direct viral infection in conjunction with expression of d ifferent cytokines is important in the pathophysiology of viral-induced liv er disease.