Thai Journal of Gastroenterology

Article :
Comparison of Clinical, Biochemical, Virological and Histopathological Characteristics Between Chronic Hepatitis C Infected Patients with Respect to Genotype 1 and 3

Author :
Varayu Prachayakul, M.D.
Phunchai Jarasjareunwittaya, M.D.
Supot Pongprasopchai, M.D.
Somchai Leelakusolvong, M.D.
Sathaporn Manasatit, M.D.
Udom Kachinthon, M.D.
Sasiprapa Boonyapisit, M.D.
Sithipol Udompunthurak
Kanit Athisuk, M.D.
Taweesak T anwandee, M.D.

Abstract :

Background: Hepatitis C virus (HCV) causes acute and often chronic hepatitis.  On the basis of varia-
tions in nucleotide sequence, at least six genotypes and several subtypes have been identified.  As genotype is considered an important determinant of disease progression and response to anti-viral therapy, we don’t know definitely about the difference of each genotype characteristics.  The aim of study is to evaluate whether clinical, biochemical, serological and distinct histopathological manifestations of HCV infection are related to particular genotypes of HCV, especially 1 and 3.

Patients and Methods: This study was the case control-retrospective study among 160 pre-treatment
chronic hepatitis C patients who underwent liver biopsy at Siriraj Hospital during 1997-2003.  Clinical, biochemical liver parameters and histopathological features was analyzed with according to genotype 1 and 3 for the correlation.

Results: The most common genotype in Thai CHC patients was 3 (57% of patients), followed by 1
(37.2%), and 6 (5.8%) which similar to Indian but different from American and European reports.  There was no correlation of clinical, biochemical parameters especially liver function tests and quantitative HCV RNA viral load between genotype 1 and 3.  However, the most prominent finding of this study is that patients infected with HCV genotype 3 have statistically significant more steatosis than patients infected with genotype 1 ( p <0.001, Odds Ratio = 10.84, 95% CI = 2.08-75.36), although they do not differ from patients infected with type 1 regarding inflammatory activity (p = 0.052), the degree of fibrosis, the presence of intrahepatic portal lymphoid aggregrates or bile duct damage.  Furthurmore, we found that there was no correlation of presence and grade of steatosis with respect to liver necro-inflammatory grading and fibrotic staging including other parameters.

Conclusion: Chronic Hepatitis C genotype 1 and 3 were the common genotype in Thailand. Both were
not different in the clinical, biochemical and histopathological features.  Only lobular steatosis was the outstanding liver histopathology in genotype 3.

[Thai J Gastroenterol 2005; 6(2): 72-80]

Keyword :
comparison, chronic hepatitis C, Genotype

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