Morphological and pathogenetical characteristics of chronic HBeAg-negative hepatitis В and chronic hepatitis С



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Abstract

Aim to compare the frequency and severity of morphological changes in chronic HBeAg-negative hepatitis В (СНВ) and hepatitis С (CHC) and define their significance in the disease pathogenesis Materials and methods. We have analyzed morphological changes in liver bioptates of 39 patients: 18 with HBeAg-negative CHB and 21 with CHC. Classical signs of histological activity, as well as small cell and large cell hepatocyte dysplasia (SCHD, LCHD) were assessed, and correlative relationships between morphological and clinico-laboratory data were determined. Results. НВѴ-infection markers were rarely found in HBeAg(-) hepatitis: "Ground-glass-like" hepatocytes were detected in 27,8 % of patients, and no «sandy» nuclei were present. Hepatocyte fatty dystrophy, stepwise necrosis and inflammatory infiltration were more frequent and more severe in patients with CHC compared to CHB. SCHD was 10-fold higher than LCHD in both types of hepatitis. Positive correlations were found between aminotransferases and inflammation intensity, fatty dystrophy, and SCHD in CHC; between number of lymphocytes, erythrocyte sedimentation rate, inflammatory infiltration and SCHD in CHB. LCHD correlated with the duration of the disease. Conclusion. Our analyses have revealed more evident morphological signs of hepatocellular inflammation in CHC than in HBeAg(-) CHB, which correlated with the clinico-laboratory signs of necrotic-inflammatory syndrome. SCHD dominated over LCHD in both types of hepatitis.

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L A Pravdolyubova

Email: pravdolyubova@mail.ru

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