Farhan Akhtar, Sajid Mushtaq, Muhammad Luqman, Shahid Jamal, Nadira Mamoon, Zahur Ur Rehman.
Histological Prognostic Markers in Interferon treated chronic Hepatitis C Patients.
J Coll Physicians Surg Pak Jan ;12(7):403-5.

Objective: To identify various predictive histological features of response to interferon-alpha (IFN-a) therapy in serologically proven HCV infected cases. Design: A prospective study. Place and Duration of Study: The study was conducted between July, 1998 to July, 2000 at the Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi. Patients and Methods: This study included 40 selected patients who were serologically positive for anti HCV. These selected patients were treated with IFN-a for 3 months. Results of pre-treatment serum alanine aminotransferase (ALT) and after 3 months of post-treatment were recorded. Results: On the basis of ALT levels before and after IFN-a treatment, responders (having normalization of serum ALT level) and partial / non responders were identified. Seventeen (42.5%) cases were found to be responders while 23 (57.5%) were partial / non responders. The significant differences in histological features seen on liver biopsy were bridging fibrosis / cirrhosis in 14 (60.8%) of non/partial responder cases as compared to 2 (11.7%) in responders. Twenty-two cases (95.6%) of partial / non responder group showed moderate to marked portal tract inflammation, 18 (78.2%) revealed moderate to marked piecemeal necrosis and 12 (52.1%) had intraparenchymal inflammation. Conclusion: The histological findings suggest that higher scores of fibrosis, portal tract and intraparenchymal inflammation, and piecemeal necrosis in liver biopsies are predictors of poor response to IFN-a therapy in chronic hepatitis C patients.

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