INFLUENCE OF THE TRANSMISSION ROUTE AND DISEASE DURATION IN THE HISTOPATHOLOGY OF CHRONIC HEPATITIS-C - A STUDY OF 101 PATIENTS

Objective Different studies have demonstrated that factors such as tra nsmission route, disease duration and age at the time of infection can influence the histological evolution of chronic hepatitis by the hepa titis C virus (HCV). The aim of this study was to determine if epidemi ological factors such as disease duration and transmission route influ ence the severity of the histological lesions of patients with chronic hepatitis by HCV. Design A prospective study. Methods The hepatic bio psies of 101 patients diagnosed with chronic hepatitis by HCV were stu died. The patients were divided into three groups according to transmi ssion mode: (1) post-transfusional (n = 28), (2) associated with the u se of drugs by parenteral route or intravenous drug use (n = 28), and (3) sporadic hepatitis (n = 45). Results We found more severe forms of hepatopathy in post-transfusional hepatitis and sporadic groups than in the intravenous drug user group of patients. The disease evolution time was significantly higher in patients diagnosed as having chronic active hepatitis with or without cirrhosis (13.8 +/- 9 years) than in patients with chronic persistent hepatitis (8 +/- 4 years), P < 0.01. We found a significant correlation between the evolution time of the i nfection by HCV and the Histology Activity Index (P < 0.01). The multi variate analysis showed that only the transmission route and the disea se evolution time are predictive variables of Histology Activity Index in chronic hepatitis C. Conclusion These results suggest that the pos ttransfusional and sporadic transmission routes and a greater evolutio n time of the disease are epidemiological variables that are associate d with the presence of more severe histological lesions in chronic hep atitis C.