[1749] Non-Alcoholic Steatohepatitis (NASH) Influences the Disease Progression of Chronic Hepatitis C

Toshiharu Matsumoto, Kanako Ogura. Juntendo University Nerima Hospital, Tokyo, Japan

Background: Non-alcoholic steatohepatitis (NASH) is a chronic liver injury with liver histology of steatosis, lobular inflammation and fibrosis (pericellular and perivenular) in nonalcoholic patients. The occasional occurrence of NASH in chronic hepatitis C (CH-C) has been reported, but the influences of NASH on the disease progression of CH-C are obscure. Therefore, in the present study, we examine the influences of NASH on the disease progression of CH-C.
Design: Liver biopsies from 400 cases with CH-C were examined histologically. The histology of CH was evaluated by the activity scores (A0, A1, A2, and A3) and fibrosis scores (F0, F1, F2, F3, and F4 = cirrhosis). NASH was evaluated by the grading (G1, G2, G3, and G4) and staging system (S1, S2, S3, and S4) according to the Brunt system (Brunt EM, et al. Am J Gastroenterol 94:2467-2474, 1999).
Results: A morphological pattern of NASH was present in 69 cases (69/400, 17%). The incidence of NASH did not correlate to the degree of activity and fibrosis of CH-C. In the 69 cases with NASH, the grade of NASH and the activity of CH-C did not correlate, but the stage of NASH and the fibrosis of CH-C significantly correlated (P < 0.001). In 18 cases (10 with F3, A2, and 8 with F3, A3) with NASH, various fibrosis patterns (portal, periportal, septal, pericellular and perivenular) causing both CH-C and NASH were admixed.

Incidence of NASH in each group of activity and fibrosis system of CH-C
A06/37 (16%)5/17 (29%)0/1 (0%)0/1 (0%)0 (0%)
A15/71 (7%)18/111 (16%)4/18 (22%)0/10 (0%)0/11 (0%)
A20/5 (0%)0/14 (0%)10/35 (28%)10/27 (37%)3/20 (15%)
A30/1 (0%)0/2 (0%)0/2 (0%)8/11 (72%)0/6 (0%)

Conclusions: In 18 cases (18/400, 4.5%), pericellular and perivenular fibrosis caused by NASH played a role on the destruction of hepatic lobular structure and the disease progression. In such cases, these changes lead to cirrhosis, so the treatment of NASH is necessary to prevent the disease progression of CH-C.
Category: Liver

Wednesday, March 21, 2012 9:30 AM

Poster Session V # 237, Wednesday Morning


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