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CORRELATION BETWEEN BIOCHEMICAL AND HISTOPATHOLOGICAL PARAMETERS IN PATIENTS WITH CHRONIC HEPATITIS C TREATED WITH PEGYLATED INTERFERON AND RIBAVIRIN
Maja Karin
; Department of Internal Medicine, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
Milenko Bevanda
; Department of Internal Medicine, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
Emil Babić
; Department of Internal Medicine, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
Mladen Mimica
; Department of Internal Medicine, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
Daniela Bevanda-Glibo
; Department of Internal Medicine, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
Mile Volarić
; Department of Internal Medicine, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
Ante Bogut
; Department of Internal Medicine, University Clinical Hospital Mostar, Mostar, Bosnia and HerzegovinaDepartment of Internal Medicine, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
Danijel Pravdić
; Department of Internal Medicine, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
Sažetak
Aim: The main goal of this study was to compare the biochemical and histopathological findings in patients with sustained virological
response (SVR) before and two years after the therapy with pegylated interferon α-2a and ribavirin in chronic hepatitis C.
Subjects and methods: The study was conducted at the Department of Internal Medicine and the Clinic for Infectious Diseases of
the Clinical Hospital Mostar. The study included 48 patients whose treatment for chronic hepatitis C with pegylated interferon α-2a
and ribavirin was finished two years prior to the achieved SVR at the end of the treatment. The main criterion for inclusion was a
negative result of HCV RNA, determined by the RealTime HCV assay. After taking a history, physical examination, laboratory tests:
AST, ALT, GGT, a liver biopsy were performed with the help of the ultrasound. The assessment of necroinflamatory score was
determined by histologic activity index (HAI) score, and the stage of fibrosis according to Knodell's numerical score.
Results: The values of AST and ALT levels were statistically significantly decreased after the successful treatment (p<0.001), as
well as the value of HAI score (p=0.001) and the stage of fibrosis (p=0.010), in contrast to GGT (p=0.054). For the components of
HAI score like focal necrosis (0.001) and portal inflammation (0.042) the result showed that they were significantly higher before the
therapy, which was not true for the piecemeal (p=0.054) and confluated necrosis (p=0.078). The improvement of HAI score after
therapy was found in 36 patients (75.0%), and 27 patients (56.2%) showed an improvement in the degree of fibrosis with the most
common improvement of 1 degree (85.7%). One third of patients (31.3%) had the same result in the degree of fibrosis before and
after the therapy. Before the treatment, a positive correlation was observed between ALT (p=0.039) and AST (p=0.04) with HAI,
AST and the stage of fibrosis (p=0.04). In contrast, after the treatment the only correlation was observed between AST and the stage
of fibrosis (p=0.042).
Conclusion: Virological and biochemical responses in patients with SVR may not reflect the histopathological effects of the
treatment and therefore these patients should be monitored for the possible development of the liver cirrhosis and hepatocellular
carcinoma.
Ključne riječi
hepatitis C; pegylated interferon; ribavirin; hepatic fibrosis; hepatocellular carcinoma
Hrčak ID:
265245
URI
Datum izdavanja:
5.11.2014.
Posjeta: 202 *