Liver histology of chronic hepatitis C patients who relapsed or not responded to conventional interferon and ribavirin therapy

Objective: To evaluate liver histology of chronic hepatitis C patients, who were relapsers or non-responders to previous conventional therapy. Methods: The descriptive case series was conducted in the Hepatology section of Medical Unit-III at the Jinnah Postgraduate Medical Centre, Karachi, Pakistan, from January to December 2008. The study had 109 hepatitis C patients who had relapsed or not responded to the conventional interferon and ribavirin for at least 24 weeks. All the patients were subjected to liver biopsy. The inflammatory activity and fibrosis shown by the liver biopsies were assessed according to the Batts-Ludwig classification. SPSS version 15 was used to analyse data. Results: A majority (n=57; 52.3%) of the 109 patients were female with hepatitis C virus genotype 3. Among these, 100 (91.7%) patients were non-responders and 9 (8.3%) were relapsers. The mean age of the patients was 38.9±8.8 years. The non-responders had elevated levels of serum aminotransferase. According to Batts-Ludwig classification, Grade 0 inflammation was not present in the non-responders and relapsers; grade 1 in 51 (46.8%); grade 2 in 47 (43.1%); grade 3 in 10 (9.2%); and grade 4 in 1(0.9%). Stage 0 fibrosis was present in 10 (9.2%); stage 1 in 34 (31.2%); stage 2 in 36 (33.0%); stage 3 in 13 (11.9%); and stage 4 in 16 (14.7%). Conclusion: Results suggested that even if it failed to eradicate hepatitis C virus, the conventional interferon and ribavirin therapy was able to halt the progress of necroinflammation and fibrosis.