The Usefulness of Histopathological Severity Index in Predicting the Response to Alpha-interferon in Patients with Chronic Hepatitis C

Jung, Yong Seok; Park, Hee Bag; Oak, Chul Ho; Jang, Young Kwang; Yun, Byung Chul; Ahn, Su Yul; Lee, Sang Uk; Han, Buung Hoon; Kim, Soon Young

Abstract

BACKGROUND/AIMS: To improve the response rate of alpha-interferon (IFN) in chronic hepatitis C, patients should be selected properly. Therefore, we assessed the usefulness of histopathological severity index in predicting the response to IFN treatment.
METHODS
We studied retrospectively 63 patients who had chronic hepatitis C and were treated with IFN (three million units, three times weekly, subcutaneously for 9 months). Histopathological severity index was evaluated in pretreated liver biopsies according to the modified Knodell's method. Thirty patients who sustained normal serum level of aspartate aminotransferase (AST) and alanine aminotransferase (ALT), and showed HCV-RNA loss for at least 6 months after discontinuation of treatment were classified as responders.
RESULTS
The histopathological severity indices of portal infiltration (p<0.005), piecemeal necrosis (p<0.005) and fibrosis (p<0.005) were significantly lower in responders than in non-responders, but lobular activity showed no difference. The total score of histopatholgical severity index was significantly lower in responders than in non-responders (p<0.005). The proportion of the patients showing histopathological changes of portal infiltration (p<0.005), piecemeal necrosis (p<0.005) and fibrosis (p<0.005) was significantly higher in responders than in non-responders.
CONCLUSIONS
Histopathological severity index of portal infiltration, piecemeal necrosis and fibrosis may provide an useful information in selecting patients with chronic hepatitis C for IFN therapy.