Response of viral hepatitis B and C to interferon alpha treatment: Possible role of MGP-Positive lymphoid cells

Abstract

Fifty-six needle liver biopsies from 28 patients with viral hepatitis B (15 cases) and hepatitis C (13 cases) treated with Interferon alpha for a minimum of six months were studied with the aim of determining the role of MGP-positive lymphoid cell infiltrates in the response to treatment with interferon. Besides assessing the MGP-positive cells, the following parameters were assessed and graded: (i) Inflammation in and around the portal tracts, (ii) fibrosis, nodularity and cirrhosis, (iii) piece-meal necrosis (inter-face hepatitis), (iv) lobular activity, (v) stainable iron. Sec-tions were stained with H&E, PAS, PASD, Perl, Masson Trichrome and MGP (Methyl Green Pyronin). All the parameters were graded 1 to 3 except stainable iron which was noted as present or absent. Fourteen patients (50%) demonstrated histological evidence of a response to treatment. Seven of these showed a very pronounced response with the post treatment liver bi-opsies returning almost to normal. Five of the seven, 27.8% of all MGP stained cases and 71% of all brisk responses, contained ten or more MGP-positive lymphoid cells in the portal tracts. In contrast, the non-responsive and worsened cases con-tained less than five MGP-positive cells as well as a pre-dominantly small mature lymphocytic infiltrate in the por-tal tracts. Severity of piece-meal necrosis, lobular activity, portal tract inflammation, the presence or absence of stainable iron, were not of predictive value in the response of viral hepatitis to treatment with interferon alpha. It appears that MGP-positive lymphoid cells, most prob-ably immune competent activated lymphoid cells, have a positive influence on, and are of predictive value for, the response to treatment of viral hepatitis B and C with inter-feron alpha.