Cathomas G, McGandy C E, Terracciano L M, Gudat F, Bianchi L
Institute for Pathology, University of Basel, Switzerland Kantonsspital, Switzerland.
Virchows Arch. 1996 Dec;429(6):353-8. doi: 10.1007/BF00198439.
This paper describes the correlation of hepatitis C genotypes detected in liver tissue with histological grading (inflammatory activity) and staging (degree of fibrosis/cirrhosis). The viral genotype was analysed by type-specific polymerase chain reaction (PCR) and correlated with histology and age of patients. In 69 patients with chronic hepatitis C (HCV) infection, genotypes 1a and 1b were detected in 13 (18.8%) and 31 (44.9%) liver biopsies, respectively. Genotypes 2a and 2b were each detected once (1.5%) and 12 (17.4%) tissue samples showed a mixed infection with two genotypes. In 11 (15.9%) biopsies, no genotype could be established. The liver specimens were grouped according to the presence or absence of genotype 1b: group A consisted of specimens infected with genotypes 1a, 2a, and 2b (n = 16), Group B contained biopsies infected with genotype 1b (n = 42), and group C were biopsies with no detectable genotype (n = 11). Activity (grade) of chronic hepatitis was not different in these three groups. However, advanced fibrosis/cirrhosis was observed in 16 (38.1%) biopsies in group B (containing genotype 1b), compared with none in group A (P = 0.01). The mean age of patients in group B was significantly higher than that in group A (P = 0.038), and the mean age of patients with advanced fibrosis was higher than that of patients with low fibrosis scores within these two groups (P = 0.004). Stepwise logistic regression revealed an independent association of age and genotype 1b (group B) with advanced fibrosis/cirrhosis. These data indicate that patients infected with genotype 1b have an higher risk of developing cirrhosis than do patients with other genotypes.
本文描述了在肝组织中检测到的丙型肝炎基因型与组织学分级（炎症活动度）和分期（纤维化/肝硬化程度）之间的相关性。通过型特异性聚合酶链反应（PCR）分析病毒基因型，并将其与患者的组织学和年龄相关联。在69例慢性丙型肝炎（HCV）感染患者中，分别在13例（18.8%）和31例（44.9%）肝活检组织中检测到1a型和1b型基因型。2a型和2b型基因型各检测到1次（1.5%），12例（17.4%）组织样本显示为两种基因型的混合感染。在11例（15.9%）活检组织中，无法确定基因型。根据是否存在1b型基因型对肝标本进行分组：A组由感染1a型、2a型和2b型基因型的标本组成（n = 16），B组包含感染1b型基因型的活检组织（n = 42），C组为未检测到基因型的活检组织（n = 11）。这三组慢性肝炎的活动度（分级）没有差异。然而，B组（含有1b型基因型）的16例（38.1%）活检组织中观察到晚期纤维化/肝硬化，而A组无一例出现（P = 0.01）。B组患者的平均年龄显著高于A组（P = 0.038），并且在这两组中晚期纤维化患者的平均年龄高于低纤维化评分患者（P = 0.004）。逐步逻辑回归显示年龄和1b型基因型（B组）与晚期纤维化/肝硬化存在独立关联。这些数据表明，感染1b型基因型的患者比感染其他基因型的患者发生肝硬化的风险更高。
