[Chronic viral hepatitis C. Anatomoclinical and biological correlations]

Abstract

Objectives: The relations between the severity of histopathological lesions and epidemiological, clinical and biological data were studied in 86 patients with chronic viral hepatitis C.

Patients and methods: None of the patients had any clinical signs of decompensated liver disease. Three groups of patients were individualized according to histopathological findings: 17 (20%) had chronic persistent hepatitis, 48 (56%) had chronic active hepatitis without cirrhosis, and 21 (24%) had cirrhosis.

Results: Patients with cirrhosis differed significantly from patients in the two other groups for all biological parameters. With multivariate analysis, alkaline phosphatase activity and serum hyaluronic acid were two independent parameters significantly associated with cirrhosis. A serum hyaluronic acid level above 150 micrograms/L or alkaline phosphatase activity above normal were predictive of cirrhosis with a sensitivity of 87% and a specificity of 93%. None of the parameters in this study provided a clear distinction between patients with chronic persistent and chronic active hepatitis.

Conclusion: Determination of serum hyaluronic acid and alkaline phosphatase activity as a non invasive index of cirrhosis could be useful for diagnosis and follow-up in patients with chronic viral hepatitis C.