Hepatitis C virus-associated hypobetalipoproteinemia is correlated with plasma viral load, steatosis, and liver fibrosis

Aim: A relationship between chronic hepatitis C virus [HCV] infection and lipid metabolism has recently been suggested. The aim of this study was to determine the correlation between lipid profile and virology, and histologic lesions in noncirrhotic, londiabetic patients with hepatitis C. Subjects and Thirty patients with untreated chronic hepatitis C were studied to assess the effects of HCV viral load, steatosis, hepatic fibrosis, and body mass ndex [BMI] on lipid profile. The control group showed a significantly higher apolipoprotein B [apo B] concentration compared with patients with chronic hepatitis C. Hypobetalipoproteinemia [apo B <0.7 g/l] was found in 8 [26.6%] chronic HCV patients and in 1 [10%] control subjects [P=0.0002]. Levels of apo B were negatively correlated with steatosis and HCV viral ioad [r= -0.22, P=0.03]. In multivariate analysis, low apo B concentration was significantly associated with fibrosis grade 2 or 3 versus grade 0 or 1 [P< 0001], stetosis > 5% [P<0.001], low body mass index [P<0.001], and high HCV viral load [P< 0.014]. Conclusions: In chronic HCV patients, hypobetalipoproteinemia occurs already in the early stages of HCV infection before the development of liver cirrhosis. The correlation between apo B levels and HCV viral load seems to confirm the interaction between hepatitis C infection and Beta-lipoprotein metabolism

Correlation between biochemical markers of liver fibrosis and histopathological features in patients with chronic hepatitis C

Aim: Liver fibrosis in chronic hepatitis C is related to sex and age at infection. Several biochemical markers are highly predictive for the discrimination of significant fibrosis. The aims of this study were to compare an index of five-biochemical markers with histological features and to determine the utility of combining historical features [age and sex] with the five-marker index for the prediction of significant fibrosis. Subjects and Thirty untreated patients with chronic hepatitis C and a known duration of infection had a liver biopsy and serum tested for markers of fibrosis. The discriminative values of the markers and an index of historical features for the diagnosis of clinically significant fibrosis [F2-F4, by the Metavir scoring system] were compared using areas under receiving operating characteristic [ROC] curves. A modified index was constructed combining the five-marker index and historical features. Of the 30 patients included 70% were males. The median age at infection was 28 +/- 13 and the median duration of infection was 17 +/- 8 years. By multivariate logistic regression analysis, sex [P=0.003], age at biopsy [P-0.004] were independently predictive of F2-F4 fibrosis. For the discrimination of F2-F4 fibrosis, the areas under ROC curves were 0.796 +/- 0.033 for the five-marker index versus 0.709 +/- 0.037 for the historical index [P=0.079]. For diagnosis of advanced fibrosis [F3, F4] the areas under the curves were 0.920 +/- 0.032 and 0.762'0.049 [P=0.007], respectively. The discriminative value of the combined biochemical and historical index was not statistically significantly different from that of the five-marker index alone [P=ns]. Conclusions: A simple index including age, sex, and five biochemical markers accurately predicts significant hepatitis C related fibrosis