Aim: To determine the histological aspects and associated factors to significant or severe fibrosis in patients with chronic viral hepatitis C.
Methods: Consecutive patients recruited between 1999 and 2005 were studied. Lecture of hepatic biopsies was performed by the same histopathologist, using the METAVIR grading.
Results: We investigated 109 patients (36 men and 73 women, mean age:49.3 years (19 - 65 years). Activity was graded A0, A1, A2 and A3 in respectively 2, 49, 51 and 7 cases. Fibrosis was graded F0, F1, F2, F3 and F4 in 3, 34, 35, 16 and 21 cases. In univariate analysis, associated factors to fibrosis more than F2 were age, diabetes, levels of ASAT, gamma glutamyl transpeptidase, alkaline phosphatase, prothrombin index and APRI score. In multivariate analysis, only age more than 50 years was associated with fibrosis more than F2 (p=0,006 adjusted OR [CI95%]:5,57[1,63 - 18,9]). Associated factors to fibrosis graded F4 were age, levels of ASAT, ALAT, gamma glutamyl transpeptidase, alkaline phosphatase, leucocytes, platelets, prothrombin index, APRI score and hepatic dysmorphy on ultrasound examination. In multivariate analysis, only APRI score more than 1,5 was associated with fibrosis graded F4 (p=0,04 adjusted OR [CI95%] :4,35 [2,25-6,76]).
Conclusion: Age and APRI score are important prognosis factors in chronic viral hepatitis C.
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