Chronic hepatitis: interest of a classification based on the presence or the absence of HBs Ag, smooth muscle antibody and microsomal antibody
Poupon, R.; Petit, J.; Bodin, F.; de Saint-Maur, P.P.; Homberg, J.C.; Darnis, F.
Gastroenterologie Clinique et Biologique 4(10): 666-673
1980
ISSN/ISBN: 0399-8320 PMID: 7439610 Document Number: 164854
The validity was shown of a classification of chronic hepatitis (CH), based on the presence of one of the following seroimmunological markers, hepatitis B surface antigen (HBsAg), smooth muscle antibody (SMA .gtoreq. 1/100) or microsomal antibody (MA .gtoreq. 1/100) or the absence of all these markers. The clinical, biological and histological features and responses to therapy were retrospectively analyzed in 115 patients with CH. Mutual exclusion of markers enabled definition of 4 groups of patients: group 1 with HBsAg only (49 patients), group 2 with SMA only (34 patients), group 3 with MA only (12 patients) and group 4 with none of these 3 markers (20 patients). In addition to the presence or absence of markers, the predominance of females or males and the degree of biochemical and histological abnormalities differentiated groups of patients. Before therapy, patients of group 2 had the most severe liver lesions and the highest prevalence of antinuclear antibody. The frequent biochemical and histological remissions observed under immunosuppressive therapy suggest that such treatment provides the highest benefit in patients in group 2. Liver damage was drug related (Ticrynafen) in a 1/3 of the patients in group III. Multidimensional analysis of the clinical, biological and histological data confirmed that groups 1, 2 and 3 were distinct entities, but that group 4 was probably nonhomogenous.