Hepatitis C virus (HCV) is a parenterally transmitted RNA virus that infects the liver and is one of the major causes of chronic liver disease. Common risk factors for infection include IV drug use, multiple sexual partners, needle-stick injury, and employment in health-care fields. HCV can be detected clinically by screening the blood for HCV antibodies and the HCV RNA test can be used to assess the degree of viral replication.

The liver biopsy often shows changes which are characteristic but not pathognomonic of HCV infection. The typical features are of chronic hepatitis with interface activity ("piecemeal necrosis"). The inflammatory infiltrate are predominantly lymphocytes with dense aggregates or lymphoid follicle formation. Steatosis with a random distribution can also be present, especially in patients infected with HCV genotype 3. Variable degrees of bile duct damage are also present. With persistent infection, fibrosis develops, with eventual bridging between portal tracts and central veins, and culminating in cirrhosis.

The biopsy shown here demonstrates the typical features of chronic HCV infection with mild activity (Laennec grade 1) and portal fibrosis with numerous septa (Laennec stage 3).

This slide shows H&E stain. See Related Content for Trichrome stain.