PATHOMORPHOLOGICAL CHANGES IN THE LIVER CAUSED BY HEPATITIS B, C, B+C VIRUSES IN THE DECEASED HIV-INFECTED PERSONS

Abstract

Pathohistological peculiarities of liver histological preparations of 75 HIV-infected deceased people with chronic viral hepatitis which diagnosed during their life: hepatitis B was in 8, C – in 24, B+C – in 43 patients. It was determined that in all patients (100.0 %), with any type of chronic hepatitis (B, C or B+C) there was a lymphocyte-macrophage infiltration of portal tracts and stroma. In persons with hepatitis B there were a focal and periportal necrosis of hepatocytes in 100.0 % of patients, hydropic dystrophy of hepatocytes - in 87.5 % and liver cirrhosis – in 25.0 %. In patients with hepatitis C a fatty dystrophy of the liver was found in 91.7 % that more often than in patients with hepatitis B (12.5 %, p<0.001), the focal periportal necrosis of hepatocytes was less (12.5 % vs. 100.0 %, respectively, p<0.001) and liver cirrhosis was in 41.7 %. In patients with hepatitis B+C, the liver tissue included signs characteristic of both hepatitis B and C: a hydropic dystrophy (69.8 %), fatty dystrophy (30.2 %), periportal bridging necrosis (51.2 %), liver fibrosis (34.9 %). As a result of these complex pathological processes in the liver, a cirrhosis was found more often than in other groups of patients (67.4 % vs. 41.7 % of patients with hepatitis C, p=0.041, and vs. 25.0 % of patients with hepatitis B, p=0.024). Histology activity index of hepatitis and stage of liver fibrosis according to Knodell R.G. (1981) did not differ in frequency in all groups of patients. In all patients a strong negative correlation was found between them (r=-0.607, p<0.001). This finding reflects a decrease in the histological activity of hepatitis against the background of increased fibrotic changes in the body. Conclusion. It has been found that the hydropic dystrophy and focal intralobular and periportal bridging necrosis of hepatocytes are characteristic of hepatitis B infection in HIV-infected deceased persons. Hepatitis C is characterized by the fatty dystrophy and cirrhosis of the liver. The presence of hepatitis B+C causes the liver changes characteristic of both hepatitis B and C simultaneously: the hydropic dystrophy, fatty dystrophy, necrosis of hepatocytes. The liver cirrhosis is most often present in patients with hepatitis B+C. The degree of liver fibrosis negatively correlated with the histology activity index of hepatitis.