Liver fibrosis assessment with semiquantitative indexes and image analysisquantification in sustained-responder and non-responder interferon-treatedpatients with chronic hepatitis C

Background/Aims: The effect of interferon on the reduction of liver fibrosi s is controversial. We aimed to compare semiquantitative methods with a qua ntitative digital image analysis system to assess liver fibrosis in biopsie s from patients with chronic hepatitis and different responses to interfero n, Methods: We studied 98 liver biopsies with chronic hepatitis C before and a fter recombinant interferon alfa-2 treatment, using conventional histologic al assessment, grading of histological activity, scoring/staging of fibrosi s (Knodell and Scheuer), and quantification of fibrosis with image analysis (FibroQuant). Results: Sustained-responders to interferon showed a significant reduction in histological lesions and in their Knodell and Scheuer activity indexes. The semiquantitative systems showed no reduction in fibrosis, The FibroQuan t application showed a significant reduction in porto-periportal and septal areas among sustained-responders (P < 0.001) and non-responders (P < 0.05) , and in porto-periportal and septal fibrosis areas only in sustained-respo nders (P < 0.001), whereas the percentage of fibrosis increased in non-resp onders (P < 0.001). Conclusions: The Scheuer system is useful for the daily evaluation of fibro sis, but the FibroQuant application provides more objective data on the ant i-fibrogenic effects of interferon, which include a reduction in the portop eriportal area in sustained-responders and non-responders, accompanied by a reduction in the area of fibrosis only when the viral replication has ceas ed. (C) 2001 European Association for the Study of the Liver. Published by Elsevier Science B,V, All rights reserved.