Clinical, virological, and pathological significance of hepatic bile duct injuries in Chinese patients with chronic hepatitis C

Purpose. Hepatic bile duct injuries are characteristic histological finding s in patients with chronic hepatitis C virus (HCV) infection. However, the pathogenesis and clinical significance of this phenomenon remain unclear. T he aims of this study were to evaluate the prevalence and clinical signific ance of hepatic bile duct injuries in Chinese patients with chronic hepatit is C. Methods. One hundred and seventeen Chinese patients with chronic hepa titis C were enrolled. Clinical, biochemical, immunological (serum autoanti bodies and cryoglobulinemia), histological, and virological data (serum HCV RNA titer and HCV genotype) were compared between patients with and withou t hepatic bile duct injuries. Results. Eighty-three (71%) of the 117 patien ts with chronic hepatitis C had hepatic bile duct injuries. Patients with h epatic bile duct injuries had a significantly higher frequency of HCV genot ype Ib; a higher mean serum globulin level; significantly higher mean score s for histological periportal necro-inflammation, portal inflammation, and fibrosis; and more severe portal lymphoid aggregation/follicles when compar ed with patients without hepatic bile duct injuries (P < 0.05, all). No sig nificant differences in the presence of serum autoantibodies, cryoglobuline mia, mean serum HCV RNA titer, or response to interferon treatment were not ed between the two groups. Multivariate logistic regression analysis showed that HCV genotype Ib infection, portal inflammation, and lymphoid aggregat ion/follicles were significant independent predictors associated with hepat ic bile duct injuries. Conclusions. The presence of hepatic bile duct injur ies in Chinese patients with chronic hepatitis C was significantly correlat ed with HCV genotype Ib infection, and the patients with these injuries had more severe portal inflammation and formation of lymphoid aggregates/folli cles.