Fibrosis in Chronic Hepatitis C: Correlation between Immunohistochemically-Assessed Virus Load with Steatosis and Cellular Iron Content

Maha Akl; Ali EL Hindawi; Maha Mosaad; Ahmed Montasser; Ahmed El Ray; Heba Khalil; Amgad Anas; Raffat Atta; Valerie Paradis; Ahmed Abdel Hadi; Olfat Hammam

doi:10.3889/oamjms.2016.122

Authors

Maha Akl Department of Pathology, Theodor Bilharz Research Institute, Imbaba, Giza
Ali EL Hindawi Department of Pathology, Faculty of Medicine Cairo University, Cairo
Maha Mosaad Department of Pathology, Faculty of Medicine Cairo University, Cairo
Ahmed Montasser Department of Pathology, Theodor Bilharz Research Institute, Imbaba, Giza
Ahmed El Ray Department of Gastroenterology, Theodor Bilharz Research Institute, Imbaba, Giza
Heba Khalil Department of Pathology, Theodor Bilharz Research Institute, Imbaba, Giza
Amgad Anas Department of Gastroenterology, Theodor Bilharz Research Institute, Imbaba, Giza
Raffat Atta Department of Gastroenterology, Theodor Bilharz Research Institute, Imbaba, Giza
Valerie Paradis Deparment of Pathology, Beaujon Hospital, Clichy
Ahmed Abdel Hadi Department of Pathology, Theodor Bilharz Research Institute, Imbaba, Giza
Olfat Hammam Department of Pathology, Theodor Bilharz Research Institute, Imbaba, Giza

DOI:

https://doi.org/10.3889/oamjms.2016.122

Keywords:

Fibrosis, HCV, HCC, NS3/NS4, VEGF, VEGFR2, FISH

Abstract

AIM: We aimed study impact of hepatocytic viral load, steatosis, and iron load on fibrosis in chronic hepatitis C and role of VEGF and VEGFR overexpression in cirrhotic cases in evolving HCC.

MATERIAL AND METHODS: Total of 120 cases were included from TBRI and Beaujon Hospital as chronic hepatitis C (CHC), post-hepatitis C cirrhosis, and HCC. Cases of CHC were stained for Sirius red, Prussian blue and immunohistochemically (IHC) for HCV-NS3/NS4. HCC were stained IHC for VEGF and by FISH.

RESULTS: Stage of fibrosis was significantly correlated with inflammation in CHC (P < 0.01). Noticed iron load did not correlate with fibrosis. Steatosis was associated with higher inflammation and fibrosis. The cellular viral load did not correlate with inflammation, steatosis or fibrosis. VEGF by IHC was significantly higher in cases of HCC when compared to cirrhotic group (P < 0.001). Amplification of VEGFR2 was confirmed in 40% of cases of HCC. Scoring of VEGF by IHC was the good indicatorÂ of VEGFR2 amplification by FISH (P < 0.005).

CONCLUSION: Grade of inflammation is the factor affecting fibrosis in CHC. The degree of liver damage is not related to cellular viral load or iron load. Steatosis is associated with higher inflammation and fibrosis. VEGF by IHC is correlated with overexpression of VEGFR2 by FISH.

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