Pathological diagnosis of chronic hepatitis C: a multicenter comparative study with chronic hepatitis B. The Hepatitis Interventional Therapy Group

Gastroenterology. 1993 Feb;104(2):595-603. doi: 10.1016/0016-5085(93)90432-c.


Background: Hepatic histological responses described in hepatitis C virus (HCV) infection include bile duct damage, lymphoid follicles and/or aggregates in portal tracts, large- and small-droplet fat, Mallory body-like material in hepatocytes, liver cell dysplasia and multinucleation, and activation of sinusoidal inflammatory cells. The specificity of these lesions for HCV infection is uncertain.

Methods: In two multicenter trials of recombinant interferon alfa therapy for chronic hepatitis C and B, the frequency of these eight lesions in pretherapy and posttherapy liver biopsy specimens was examined to determine the set of features, if any, that distinguishes HCV from hepatitis B virus (HBV) infection. The lesions were scored in 317 HCV biopsy specimens and 299 HBV specimens.

Results: Stepwise logistic regression determined a set of three features more likely to be seen in HCV than in HBV infection: bile duct damage [odds ratio (OR), 4.7; 95% confidence interval (Cl), 1.8-12.3], lymphoid follicles and/or aggregates (OR, 2.4; 95% Cl, 1.2-4.7), and large-droplet fat (OR, 2.4; 95% Cl, 1.4-4.1). A fourth lesion, Mallory body-like material, was seen only in HCV biopsy specimens (OR, 71.6; 95% Cl, 4.4-996.1).

Conclusions: These four histological lesions are useful pathological parameters in the diagnosis of liver disease caused by HCV.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Biopsy
  • Chronic Disease
  • Cytodiagnosis
  • Hepatitis B / diagnosis
  • Hepatitis B / pathology*
  • Hepatitis B / therapy
  • Hepatitis C / diagnosis
  • Hepatitis C / pathology*
  • Hepatitis C / therapy
  • Humans
  • Interferon Type I / therapeutic use
  • Liver / pathology
  • Recombinant Proteins


  • Interferon Type I
  • Recombinant Proteins