Hepatic giant cells in hepatitis C virus (HCV) mono-infection and HCV/HIV co-infection

S. T L Micchelli, David L Thomas, J. K. Boitnott, M. Torbenson

Research output: Contribution to journalArticle

Abstract

Background: The clinical and biological significance of syncytial giant cell change of hepatocytes in hepatitis C viral (HCV) infection is poorly understood. Aim: To investigate the clinical and histological correlates of giant cell transformation in the setting of HCV mono-infection and co-infection with HCV and HIV. Methods: The prevalence of hepatocyte giant cell transformation was determined and serological, biochemical and histological findings examined. Results: Among 856 liver biopsy specimens, 22 cases (2.6%) showed giant cell transformation, representing 18 individuals. The median serum ALT was 37 IU/l, AST 49 IU/l, and alkaline phosphatase 97 IU/l. Eleven cases had HCV RNA loads available, with a median HCV RNA of 5.52 log IU/ml. Twelve of 17 individuals with available test results were also HIV positive (71%), compared to 46% of controls (p = 0.08). Giant cell transformation was found exclusively in zone 3 hepatocytes; the accompanying histological findings were otherwise typical of chronic HCV. The hepatic giant cells typically had a cytoplasmic appearance that resembled smooth endoplasmic reticulum proliferation. Most cases had only mild inflammation and fibrosis, with a median modified hepatic activity index (MHAI) grade of 3/18 and a median MHAI stage of 1/6. Three individuals had follow-up biopsies; all continued to have giant cell change. Conclusion: Giant cell transformation occurs most commonly in the setting of HCV/HIV co-infection, but can also be seen in chronic HCV infection alone. Histologically, giant cells were located in zone 3 hepatocytes, were persistent over time, and do not appear to be a marker of aggressive hepatitis.

Original languageEnglish (US)
Pages (from-to)1058-1061
Number of pages4
JournalJournal of Clinical Pathology
Volume61
Issue number9
DOIs
StatePublished - 2008

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Virus Diseases
Giant Cells
Coinfection
Hepacivirus
HIV Infections
Hepatocytes
Chronic Hepatitis C
Liver
HIV
RNA
Biopsy
Smooth Endoplasmic Reticulum
Hepatitis C
Hepatitis
Alkaline Phosphatase
Fibrosis
Inflammation
Serum

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Medicine(all)

Cite this

Hepatic giant cells in hepatitis C virus (HCV) mono-infection and HCV/HIV co-infection. / Micchelli, S. T L; Thomas, David L; Boitnott, J. K.; Torbenson, M.

In: Journal of Clinical Pathology, Vol. 61, No. 9, 2008, p. 1058-1061.

Research output: Contribution to journalArticle

Micchelli, S. T L ; Thomas, David L ; Boitnott, J. K. ; Torbenson, M. / Hepatic giant cells in hepatitis C virus (HCV) mono-infection and HCV/HIV co-infection. In: Journal of Clinical Pathology. 2008 ; Vol. 61, No. 9. pp. 1058-1061.
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abstract = "Background: The clinical and biological significance of syncytial giant cell change of hepatocytes in hepatitis C viral (HCV) infection is poorly understood. Aim: To investigate the clinical and histological correlates of giant cell transformation in the setting of HCV mono-infection and co-infection with HCV and HIV. Methods: The prevalence of hepatocyte giant cell transformation was determined and serological, biochemical and histological findings examined. Results: Among 856 liver biopsy specimens, 22 cases (2.6{\%}) showed giant cell transformation, representing 18 individuals. The median serum ALT was 37 IU/l, AST 49 IU/l, and alkaline phosphatase 97 IU/l. Eleven cases had HCV RNA loads available, with a median HCV RNA of 5.52 log IU/ml. Twelve of 17 individuals with available test results were also HIV positive (71{\%}), compared to 46{\%} of controls (p = 0.08). Giant cell transformation was found exclusively in zone 3 hepatocytes; the accompanying histological findings were otherwise typical of chronic HCV. The hepatic giant cells typically had a cytoplasmic appearance that resembled smooth endoplasmic reticulum proliferation. Most cases had only mild inflammation and fibrosis, with a median modified hepatic activity index (MHAI) grade of 3/18 and a median MHAI stage of 1/6. Three individuals had follow-up biopsies; all continued to have giant cell change. Conclusion: Giant cell transformation occurs most commonly in the setting of HCV/HIV co-infection, but can also be seen in chronic HCV infection alone. Histologically, giant cells were located in zone 3 hepatocytes, were persistent over time, and do not appear to be a marker of aggressive hepatitis.",
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