Pathology of hepatitis C.

Damage and necrosis of hepatocytes in viral hepatitis C is considered to be immune mediated as in hepatitis B. Hepatocellular necrosis accompanies infiltration of lymphocytes and this feature, called necroinflammation, characterizes all types of viral hepatitis and corresponds to the histological expression of hepatitis. Although the histological features of hepatitis C do not differ fundamentally from those of hepatitis B, there are some quantitative differences. Weak but constant necroinflammation and a strong lymphocytic reaction of the portal tracts appear to be relatively unique to chronic hepatitis C. Nearly all chronic hepatitis C cases do not improve during the natural course of infection; however, in a limited number of cases, interferon treatment can eliminate the virus leading to normalization. The pattern and extent of fibrosis can roughly predict the efficacy of interferon treatment.