Hepatitis C: a disease with a wide morphological spectrum?

We describe the pathological findings of 50 biopsies of Mexican (Mestizo, or mixed race, usually Indian and white heritage) patients with hepatitis C infection confirmed by a second generation test. Although half of the patients were asymptomatic, the histological examination revealed advanced stages of disease. Chronic active hepatitis was found in 26 cases, cirrhosis in 23, and acute hepatitis in one case. Common histological changes included steatosis, lymphoid aggregates, and apoptotic bodies, whereas indisputable bile duct damage was observed in only four cases. Comparison with other series in which different types of populations were analyzed revealed a wide morphological spectrum with respect to some histological changes and the type of hepatitis reported. The apparently contradictory results found in the literature indicate the need to apply universal histological criteria in biopsies of patients with hepatitis C.