ABSTRACT

We studied patients with chronic hepatitis C virus (HCV) infection for the presence ofliver steatosis, examined relationships between steatosis and host factors, v;ral factors, and portal fibrosis.

Twenty subfects with confirmed chronic HCV infection were enrolled in the study. The exclusion cnteria included history of alcohol abuse, serological evidence of hepatitis B virus and/or human immunodeficiency virus,interferon or immunosuppressive treatment, obesity (body mass index >32 kglm'), concommitant liver disease, or presence of systemic disease. The host parameters studied were age, gender, body mass index, and serum levels of cholesterol, triglyceride, and ferritin. We also investigated viral factors of HCV genotype and serum HCV viral load. Liver biopsy specimens were examined and graded for steatosis and portal fibrosis. Data were analyzed according to presence or absence of steatosis, and on the basis of the various grades of fatty degeneration and fibrotic change.

Twelve of the patients were men, and the mean patient age was 46.25 ± 11.34 years (range. 20-61 years). All patients were of HCV genotype 1b. Histopathological examination revealed that five patients (2(J'A) had no signs of fatty degeneration in the liver. All these individuals were men. The severity of steatosis was grade 1 m 6, grade 2 in 4, and grade 3 in 5 patients. Portal fibrosis was grade 1 in 10, grade 2 in 5 and grade 3 in 5 patients. Steatosis was more severe in the female sub(ects (p<0.05). Serum ferritin level was strongly correlated with grade o fibrosis. There were significant associations between steatosis and age, gender. serum ferritin level, and serum HCV viral load levels. Regression analysis and kappa statistics showed that steatosis is an independent predictor o portal fibrosis.

The study indicated that steatosis, and probably also iron, play important roles in the 'development of portal fibrosis in chronic HCV infection.