Mild abnormalities in liver histology associated with chronic hepatitis: distinction from normal liver histology.

Abstract

Background-Chronic hepatitis C virus infection associated with contaminated anti-D immunoglobulin has become an issue of recent concern. The clinical course of chronic hepatitis C infection is unpredictable and histological assessment is felt to be the most reliable means of assessing disease status. Semiquantitative scoring systems have been devised, which assess degree of necroinflammatory disease activity (grade) and extent of disease progression with fibrosis (stage) in chronic hepatitis. Often, using these systems, biopsies of anti-D associated chronic hepatitis C cases show mild changes only, with low scores. The significance of these low scores is uncertain. Aims-To evaluate the significance of low scores in chronic hepatitis. Methods-Liver biopsies were assessed from two groups of patients in whom liver histology would be expected to be normal: 30 cases of Gilbert's syndrome and 13 necropsy cases of young people (< 45 years) with no history or risk factors for liver disease. These biopsies were scored using the histological activity index of Knodeil et al and its recent modification (separation of scores for grade and stage) by Ishak et al. Results-Twenty of 30 cases of Gilbert's syndrome and 11 of the 13 necropsy cases had chronic hepatitis scores of 1 or 2, whereas only eight cases of Gilbert's and two necropsy cases had scores of 0. The remaining two Gilbert's cases had scores of 3 and 5. Similar results were found using both the histological activity index of Knodeli et al and the method of Ishak et al. Conclusion-The finding of low but positive scores using these systems in people with normal liver histology questions the reliability and significance of finding such scores in patients with chronic hepatitis and is of particular concern in the evaluation of chronic hepatitis C infection. (C Clin Pathol 1997;50:929-931)

Intrahepatic Hepatitis C Viral Rna Status of Serum Polymerase Chain Reaction-Negative Individuals With Histological Changes on Liver Biopsy

“…This conclusion is supported by data from another Irish study that examined liver biopsies from Irish anti-D patients with low HAI scores and individuals with normal liver histology and concluded that liver biopsies from patients with chronic HCV infection showing minimal or mild abnormality may not necessarily be distinguished reliably from individuals with normal liver histology. 21 In conclusion, the results from this study do not support the suggestion that serum PCR-negative individuals have similar clinical, histological and virological profiles as serum PCR-positive individuals. On the contrary, the findings from this study suggest that negative serum PCR status appears to reflect "cleared past exposure" in liver particularly when mild histological abnormalities are present.…”

Modulation of cancer signalling pathway(s) in two -stage mouse skin tumorigenesis by annonacin

“…Current results also showed a very mild score of inflammation and microvesicular steatosis observed in the liver (Group IV) as compared to the carcinogen control (Group II). The weak occurrences of inflammation scattered in few areas of both liver and kidney tissues in all groups are considered normal condition [60, 61]. In addition, very mild occurrence of microvesicular steatosis in the liver observed in mice treated with annonacin alone (Group IV) is also deduced as a normal condition, mainly regarded as an adaptive mechanism towards the accumulation of toxic compound.…”

Assessment of Liver Disease and Biochemical and Immunological Markers in Swedish Blood Donors with Isolated GB Virus C&sol;Hepatitis G Virus Viremia

“…The significance of mild portal inflammatory lesions is, however, debatable. Kay et al [18]have found a high prevalence of lymphocyte aggregates in portal zones in liver biopsies from presumably normal subjects, and have claimed that such lesions represent a part of the spectrum of normal liver histology in most cases, and should not necessarily be interpreted as mild chronic hepatitis.…”