PATHOMORPHOLOGICAL CHANGES IN THE LIVER CAUSED BY HEPATITIS B, C, B+C VIRUSES IN THE DECEASED HIV-INFECTED PERSONS
DOI:
https://doi.org/10.11603/1681-2727.2023.4.14243Keywords:
immunodeficiency, viral infection, hepatitis, liver fibrosis, liver cirrhosisAbstract
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.
References
Huerta, L., Anaya-Covarrubias, J. Y., & Fierro, N. A. (2019). Human immunodeficiency virus and the liver: The impact of coinfection with hepatotropic viruses. Annals of Hepatology, 18(2), 285–286. https://doi.org/10.1016/j.aohep.2019.03.002 DOI: https://doi.org/10.1016/j.aohep.2019.03.002
McKee, G., Butt, Z. A., Wong, S., Salway, T., Gilbert, M., Wong, J., Alvarez, M., Chapinal, N., Darvishian, M., Tyndall, M. W., Krajden, M., & Janjua, N. Z. (2018a). Syndemic characterization of HCV, HBV, and HIV co-infections in a large population based cohort study. EClinicalMedicine, 4-5, 99–108. https://doi.org/10.1016/j.eclinm.2018.10.006 DOI: https://doi.org/10.1016/j.eclinm.2018.10.006
Masroor, H., Qazi, U. M., Masroor, A., Saleem, A., Khalil, G., & Abbas, K. (2021). Coinfection of hepatitis B and hepatitis C virus in patients with human immunodeficiency virus. Cureus. https://doi.org/10.7759/cureus.16474 DOI: https://doi.org/10.7759/cureus.16474
Vysotska, O. I., & Golubovska, O. A. (2018). Problems of counteracting the spread of socially dangerous blood-borne viral infections in the modern system of public health in Ukraine: The role of primary health care. Ukr. Nation S. Health, 3(50), 11–16. http://nbuv.gov.ua/UJRN/Uzn_2018_3_4
Volosevich, I., Savchuk, D., & Lopatenko, G. (2021). Research on the availability of treatment co-infection, HIV-hepatitis C. Analytical report. SI “Public Health Center of the Ministry of Health of Ukraine. https://phc.org.ua/sites/default/files/users/user92/Analitychnyj-zvit-VGS.pdf
Antonenko, Z., & Martsynovska, V. (2022). HIV-infection in Ukraine. Newsletter (53). SI “Public Health Center of the Ministry of Health of Ukraine. https://phc.org.ua/sites/default/files/users/user90/HIV_in_UA_53_2022_EN.pdf
Ganesan, M., Poluektova, L. Y., Kharbanda, K. K., & Osna, N. A. (2018). Liver as a target of human immunodeficiency virus infection. World Journal of Gastroenterology, 24(42), 4728–4737. https://doi.org/10.3748/wjg.v24.i42.4728 DOI: https://doi.org/10.3748/wjg.v24.i42.4728
Ruiz, G. O., Herrera, C. F. L., Bohórquez, J. A. M., & Betancur, J. E. (2022). Mortality in patients with acquired human immunodeficiency virus infection hospitalized in an intensive care unit during the period 2017–2019. Scientific Reports, 12(1). https://doi.org/10.1038/s41598-022-19904-z DOI: https://doi.org/10.1038/s41598-022-19904-z
Ganesan, M., Poluektova, L. Y., Kharbanda, K. K., & Osna, N. A. (2019). Human immunodeficiency virus and hepatotropic viruses co-morbidities as the inducers of liver injury progression. World Journal of Gastroenterology, 25(4), 398–410. https://doi.org/10.3748/wjg.v25.i4.398 DOI: https://doi.org/10.3748/wjg.v25.i4.398
Thornton, A. C., Jose, S., Bhagani, S., Chadwick, D., Dunn, D., Gilson, R., Main, J., Nelson, M., Rodger, A., Taylor, C., Youssef, E., Leen, C., Gompels, M., Kegg, S., Schwenk, A., & Sabin, C. (2017). Hepatitis B, hepatitis C, and mortality among HIV-positive individuals. AIDS, 31(18), 2525–2532. https://doi.org/10.1097/qad.0000000000001646 DOI: https://doi.org/10.1097/QAD.0000000000001646
Yen, D. W., & Sherman, K. E. (2022). Causes and outcomes of hepatic fibrosis in persons living with HIV. Current Opinion in HIV and AIDS, 17(6), 359–367. https://doi.org/10.1097/coh.0000000000000760 DOI: https://doi.org/10.1097/COH.0000000000000760
Mocroft, A., Geressu, A., Beguelin, C., Llibre, J. M., Lazarus, J. V., Tomazic, J., Smidt, J., Parczewski, M., Brännström, J., Sedlacek, D., Degen, O., van der Valk, M., Paduta, D., Flamholc, L., Schmid, P., Orkin, C., Nielsen, L. N., Hoffmann, C., Beniowski, M., ... Peters, L. (2022). The role of HIV/hepatitis B virus/hepatitis C virus RNA+ triple infection in end-stage liver disease and all-cause mortality in Europe. AIDS, 37(1), 91–103. https://doi.org/10.1097/qad.0000000000003406 DOI: https://doi.org/10.1097/QAD.0000000000003406
Benmassaoud, A., Nitulescu, R., Pembroke, T., Halme, A. S., Ghali, P., Deschenes, M., Wong, P., Klein, M. B., & Sebastiani, G. (2018). Liver-related Events in Human Immunodeficiency Virus–infected Persons With Occult Cirrhosis. Clinical Infectious Diseases, 69(8), 1422–1430. https://doi.org/10.1093/cid/ciy1082 DOI: https://doi.org/10.1093/cid/ciy1082
Bahrii, M., Dibrova, V., Popadynets, O., & Hryschuk, M. (2016). Methods of morphological research. New book. http://nbuv.gov.ua/UJRN/Morphology_2016_10_1_20
Bahrii, M., Mykhailiuk, I., & Golubev, V. (2006). A device for obtaining a microscopic image of histological preparations (Patent of Ukraine № u200603466).
Singh, K. P., Pallett, L. J., Singh, H., Chen, A., Otano, I., Duriez, M., Rombouts, K., Pinzani, M., Crane, M., Fusai, G., Avihingsanon, A., Lewin, S. R., & Maini, M. K. (2022). Pro-fibrogenic role of alarmin HMGB1 in HIV-HBV co-infection. AIDS, Publish Ahead of Print. https://doi.org/10.1097/qad.0000000000003435 DOI: https://doi.org/10.1097/QAD.0000000000003435
Sterling, R. K., Wahed, A. S., King, W. C., Kleiner, D. E., Khalili, M., Sulkowski, M., Chung, R. T., Jain, M. K., Lisker-Melman, M., Wong, D. K., & Ghany, M. G. (2019). Spectrum of Liver Disease in Hepatitis B Virus (HBV) Patients Co-infected with Human Immunodeficiency Virus (HIV): Results of the HBV-HIV Cohort Study. American Journal of Gastroenterology, 114(5), 746–757. https://doi.org/10.1038/s41395-018-0409-9 DOI: https://doi.org/10.1038/s41395-018-0409-9
Marks, K. M., Petrovic, L. M., Talal, A. H., Murray, M. P., Gulick, R. M., & Glesby, M. J. (2005). Histological Findings and Clinical Characteristics Associated with Hepatic Steatosis in Patients Coinfected with HIV and Hepatitis C Virus. The Journal of Infectious Diseases, 192(11), 1943–1949. https://doi.org/10.1086/497608 DOI: https://doi.org/10.1086/497608
McLauchlan, J. (2009). Lipid droplets and hepatitis C virus infection. Biochimica et Biophysica Acta (BBA) - Molecular and Cell Biology of Lipids, 1791(6), 552–559. https://doi.org/10.1016/j.bbalip.2008.12.012 DOI: https://doi.org/10.1016/j.bbalip.2008.12.012
Perazzo, H., Cardoso, S. W., Yanavich, C., Nunes, E. P., Morata, M., Gorni, N., da Silva, P. S., Cardoso, C., Almeida, C., Luz, P., Veloso, V. G., & Grinsztejn, B. (2018). Predictive factors associated with liver fibrosis and steatosis by transient elastography in patients with HIV mono-infection under long-term combined antiretroviral therapy. Journal of the International AIDS Society, 21(11), e25201. https://doi.org/10.1002/jia2.25201 DOI: https://doi.org/10.1002/jia2.25201
Lin, W., Weinberg, E. M., Tai, A. W., Peng, L. F., Brockman, M. A., Kim, K., Kim, S. S., Borges, C. B., Shao, R., & Chung, R. T. (2008). HIV Increases HCV Replication in a TGF-β1–Dependent Manner. Gastroenterology, 134(3), 803–811. https://doi.org/10.1053/j.gastro.2008.01.005 DOI: https://doi.org/10.1053/j.gastro.2008.01.005
Akil, A., Endsley, M., Shanmugam, S., Saldarriaga, O., Somasunderam, A., Spratt, H., Stevenson, H. L., Utay, N. S., Ferguson, M., & Yi, M. (2019). Fibrogenic Gene Expression in Hepatic Stellate Cells Induced by HCV and HIV Replication in a Three Cell Co-Culture Model System. Scientific Reports, 9(1). https://doi.org/10.1038/s41598-018-37071-y DOI: https://doi.org/10.1038/s41598-018-37071-y
Bonnardel, J., T’Jonck, W., Gaublomme, D., Browaeys, R., Scott, C. L., Martens, L., Vanneste, B., De Prijck, S., Nedospasov, S. A., Kremer, A., Van Hamme, E., Borghgraef, P., Toussaint, W., De Bleser, P., Mannaerts, I., Beschin, A., van Grunsven, L. A., Lambrecht, B. N., Taghon, T., ... Guilliams, M. (2019). Stellate Cells, Hepatocytes, and Endothelial Cells Imprint the Kupffer Cell Identity on Monocytes Colonizing the Liver Macrophage Niche. Immunity, 51(4), 638–654.e9. https://doi.org/10.1016/j.immuni.2019.08.017 DOI: https://doi.org/10.1016/j.immuni.2019.08.017
Zhang, L., & Bansal, M. B. (2020). Role of Kupffer Cells in Driving Hepatic Inflammation and Fibrosis in HIV Infection. Frontiers in Immunology, 11. https://doi.org/10.3389/fimmu.2020.01086 DOI: https://doi.org/10.3389/fimmu.2020.01086
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 М. В. Прокопович, І. Г. Грижак, М. М. Багрій, В. М. Костюк
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Journal Infectious Disease (Infektsiini Khvoroby) allows the author(s) to hold the copyright without registration
Users can use, reuse and build upon the material published in the journal but only for non-commercial purposes
This journal is available through Creative Commons (CC) License BY-NC "Attribution-NonCommercial" 4.0
