May hepatic granulomas be part of the histological spectrum of chronic hepatitis C?
While older large series of patients with hepatic granulomas have found sarcoidosis and tuberculosis to be the most common causes of hepatic granulomas, recent works have noted some patients with chronic hepatic C and hepatic granulomas and no other obvious associations. Today, patients that undergo liver biopsy often have chronic hepatitis C that is being staged prior to possible anti viral therapy. The age of HIV and immunosuppression for organ transplants has also made opportunistic infections associated with hepatic granulomas more likely. A research article published on 7 November 2008 in the World Journal of Gastroenterology addresses this question. The research team led by Ned Snyder from the University of Texas medical branch report a retrospective study of over 4 000 liver biopsies as well as a prospective study of 240 patients with chronic hepatitis C undergoing routine liver biopsies. They found that the most common association for hepatic granulomas was chronic hepatitis C.
