The relationship between viral load of hepatitis B and C with pathologic necroinflammatory grade and fibrotic stage of hepatitis in liver biopsy

Objective: Hepatitis B and C are one of the most important causes of chronic hepatitis in developing countries. Liver needle biopsy and histopathology of liver parenchyma are one of the most accurate methods for assessing the severity of inflammation and fibrosis in these patients, which is based on Knodell s standard system. The aim of this study was to investigate the relationship between viral load of hepatitis B and C in PCR with pathologic necro-inflammatory grade and fibrotic stage of hepatitis in liver biopsy of patients with viral hepatitis.Materials and Methods: After diagnosis of viral hepatitis based on positive HBSAg or HCVAb, PCR was done for patients to determine viral load using Roche real-time PCR device and kit. Then the patients referred for liver needle biopsy and pathologic evaluation performed to determine the grade and stage of viral hepatitis by using 5 micron sections stained with H&E, Masson Trichrom and Reticulin in unique center. Data was analyzed using SPSS16 software.Results: The results of this study showed that there is a significant relationship between viral load and grade of hepatitis B. In the hepatitis C group, the relationship between viral load and modified grade was statistically significant too. No association was found between viral load of hepatitis B and C and fibrotic stage of hepatitis. Also, relationship between spotty necrosis and portal inflammation with viral load of hepatitis B and relationship between periportal interface hepatitis and viral load of hepatitis C were statistically significant.Conclusion: Despite the association between viral load in PCR and necro-inflammatory grade in the histopathology of liver needle biopsy, which has been proven in previous studies, the relation between viral load and fibrotic stage is rejected, which can be affected by the duration of the disease. Also, the difference in the relationship between necro-inflammatory grading components with the amount of viral load in various studies, suggests other influential factors such as the immune system parameters in this regard.

کلیدواژه ها:

Viral load ، necro-inflammatory grade ، fibrotic stage ، Hepatitis B ، Hepatitis C