{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:13:34Z","timestamp":1785420814221,"version":"3.56.0"},"reference-count":79,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Polytechnic University of Bucharest","award":["PubArt publication support programme"],"award-info":[{"award-number":["PubArt publication support programme"]}]},{"award":["PubArt publication support programme"],"award-info":[{"award-number":["PubArt publication support programme"]}],"id":[{"id":"https:\/\/ror.org\/0558j5q12","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Background: Chronic hepatitis B and C remain major causes of progressive liver disease, while HBV\u2013HCV coinfection is associated with accelerated fibrosis and hepatocellular injury. Methods: This study evaluated integrated biochemical, histopathological, and immunohistochemical features in patients with chronic hepatitis B (CHB, n = 29), chronic hepatitis C (CHC, n = 15), and CHB+C coinfection (CHB+C, n = 10). Liver biopsies were assessed using Ishak and METAVIR scoring systems, alongside immunohistochemical analysis of \u03b1-smooth muscle actin (\u03b1-SMA), transforming growth factor-\u03b21 (TGF-\u03b21), CD5L, and glial fibrillary acidic protein (GFAP), quantified by H-score. These findings were correlated with biochemical, hematological, and prognostic parameters. Results: Coinfected patients exhibited significantly higher serum ALT, AST, and GGT levels (p \u2264 0.011) and increased CD5L expression (median H-score 197.5 vs. 135 in CHB, p = 0.009), indicating enhanced macrophage-associated inflammatory activity. Although fibrosis stages were comparable across groups, median H-scores for \u03b1-SMA, TGF-\u03b21, and GFAP showed a consistent upward trend in CHB+C, suggesting intensified profibrogenic signaling. Principal Component Analysis identified distinct biochemical clusters related to hepatocellular injury, hepatic functional impairment (synthetic and excretory axis), and lipid metabolism. Conclusions: These findings highlight a multidimensional pattern of liver injury in chronic viral hepatitis, with CHB+C coinfection amplifying profibrogenic and hepatocellular markers, both biochemically and histologically.<\/jats:p>","DOI":"10.3390\/diseases14050165","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T19:35:43Z","timestamp":1778528143000},"page":"165","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Unified Histopathological Framework of Liver Fibrogenesis in Chronic Viral Hepatitis B, C and Coinfection"],"prefix":"10.3390","volume":"14","author":[{"given":"Alina","family":"Dumitrache (P\u0103unescu)","sequence":"first","affiliation":[{"name":"Doctoral School, University of Medicine and Pharmacy of Craiova, Petru-Rare\u0219 Street No. 2, 200349 Craiova, Romania"},{"name":"Department of Natural Sciences, National University of Science and Technology Politehnica Bucharest, Pite\u015fti University Centre, 1st Targul din Vale Str., 110040 Pitesti, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicoleta Anca","family":"Ionescu (\u0218u\u021ban)","sequence":"additional","affiliation":[{"name":"Department of Natural Sciences, National University of Science and Technology Politehnica Bucharest, Pite\u015fti University Centre, 1st Targul din Vale Str., 110040 Pitesti, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liliana Cristina","family":"Soare","sequence":"additional","affiliation":[{"name":"Department of Natural Sciences, National University of Science and Technology Politehnica Bucharest, Pite\u015fti University Centre, 1st Targul din Vale Str., 110040 Pitesti, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0391-7629","authenticated-orcid":false,"given":"Maria Cristina","family":"Ponepal","sequence":"additional","affiliation":[{"name":"Department of Natural Sciences, National University of Science and Technology Politehnica Bucharest, Pite\u015fti University Centre, 1st Targul din Vale Str., 110040 Pitesti, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana C\u0103t\u0103lina","family":"\u021a\u00e2n\u021bu","sequence":"additional","affiliation":[{"name":"Doctoral School, University of Medicine and Pharmacy of Craiova, Petru-Rare\u0219 Street No. 2, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1038-7953","authenticated-orcid":false,"given":"Monica Marilena","family":"\u021a\u00e2n\u021bu","sequence":"additional","affiliation":[{"name":"Department of Medical Assistance and Physical Therapy, National University of Science and Technology Politehnica Bucharest, Pite\u015fti University Centre, 1st Targul din Vale Str., 110040 Pitesti, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ileana Monica","family":"Bani\u021b\u0103","sequence":"additional","affiliation":[{"name":"Doctoral School, University of Medicine and Pharmacy of Craiova, Petru-Rare\u0219 Street No. 2, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u0103t\u0103lina Gabriela","family":"Pisoschi","sequence":"additional","affiliation":[{"name":"Doctoral School, University of Medicine and Pharmacy of Craiova, Petru-Rare\u0219 Street No. 2, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2016). 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