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Combining semiquantitative measures of fibrosis and qualitative features of parenchymal remodelling to identify fibrosis regression in hepatitis C: a multiple biopsy study
Author(s) -
Pattullo Venessa,
Thein HlaHla,
Heathcote Elizabeth Jenny,
Guindi Maha
Publication year - 2012
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/j.1365-2559.2012.04249.x
Subject(s) - fibrosis , medicine , hepatic fibrosis , liver biopsy , biopsy , gastroenterology , histopathology , stage (stratigraphy) , pathology , biology , paleontology
Pattullo V, Thein H‐H, Heathcote E J & Guindi M
(2012) Histopathology 61, 473–487 Combining semiquantitative measures of fibrosis and qualitative features of parenchymal remodelling to identify fibrosis regression in hepatitis C: a multiple biopsy study Aims: A fall in hepatic fibrosis stage may be observed in patients with chronic hepatitis C (CHC); however, parenchymal architectural changes may also signify hepatic remodelling associated with fibrosis regression. The aim of this study was to utilize semiquantitative and qualitative methods to report the prevalence and factors associated with fibrosis regression in CHC. Methods and results: Paired liver biopsies were scored for fibrosis (Ishak), and for the presence of eight qualitative features of parenchymal remodelling, to derive a qualitative regression score (QR score). Combined fibrosis regression was defined as ≥2‐stage fall in Ishak stage (Reg‐I) or <2‐stage fall in Ishak stage with a rise in QR score (Reg‐Qual). Among 159 patients (biopsy interval 5.4 ± 3.1 years), Reg‐I was observed in 12 (7.5%) and Reg‐Qual in 26 (16.4%) patients. The combined diagnostic criteria increased the diagnosis rate for fibrosis regression (38 patients, 23.9%) compared with use of Reg‐I alone ( P < 0.001). Combined fibrosis regression was observed in nine patients (50%) who achieved sustained virological response (SVR), and in 29 of 141 (21%) patients despite persistent viraemia. SVR was the only clinical factor associated independently with combined fibrosis regression (odds ratio 3.05). Conclusions: The combination of semiquantitative measures and qualitative features aids the identification of fibrosis regression in CHC.