NONINVASIVE ASSESSMENT OF INFLAMMATORY ACTIVITY AND FIBROSIS (GRADE AND STAGE) IN CHRONIC HEPATITIS-C INFECTION

Background: Much effort has been expended in finding non-invasive alte rnatives to percutaneous liver biopsy for assessing the histological e xtent of liver damage. Methods: We have evaluated the relationship bet ween various histological features of liver biopsies and plasma levels of immunoglobulin G (IgG), procollagen III propeptide (PIIIP) and typ e-IV collagen (CL-IV) in 109 patients with chronic hepatitis C (HCV) i nfection. Results: The serum IgG level was the best single marker for distinguishing chronic persistent hepatitis (CPH) from chronic active hepatitis (CAR). The mean serum levels of PIIIP and CL-IV increased wi th the progression of liver disease, though the three variables manife sted considerable overlap in individual values as markers of CPH, CAH and cirrhosis. The various biochemical markers correlated weakly but s ignificantly to both histological grade and stage of liver disease, as assessed with the scoring system of Knodell. The correlation appeared to be non-specific and to reflect inflammatory activity as well as fi brogenesis. Conclusions: Serum levels of PIIIP, CL-IV and IgG are of l imited use in predicting the histological grade and stage of liver dis ease in patients with chronic HCV infection.