โ Scribed by Paul D. Berk
No coin nor oath required. For personal study only.
Most patients infected with hepatitis C virus (HCV) develop chronic hepatitis. Unfortunately, the pathological evolution of this disease over time is not completely understood. We studied 70 HCV-positive patients, from whom 2 to 10 liver biopsy specimens (mean, 3.9) had been obtained during an interval of 1 to 26 years (mean, 8.8 years). Each biopsy specimen was evaluated independently by four pathologists who each provided a numerical score for the grade of portal/periportal necroinflammation (0-4), grade of lobular necroinflammation (0-4), their sum (final grade), and the stage of fibrosis (1-4). The scores were correlated with progression of disease, if any, and transition to cirrhosis. During followup, 35 patients (50%) developed cirrhosis. Cirrhosis developed in all patients with high final grade (>5) of necroinflammation on initial biopsy who were followed for 10 years and in 96% of pa- S14 BERK HEPATOLOGY, February 2006
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