Prevalence of hepatic steatosis in Egyptian patients with chronic hepatitis C [CHC] virus infection and histopathological correlation

ABSTRACT

Hepatic steatosis is a histological characteristic in patients with chronic hepatitis C [CHC] virus infection. It has been proposed that hepatic steatosis is a cytopathic effect of hepatitis C virus genotype 3a, but not other genotypes. Several studies have demonstrated that more than 90% of [CHC] patients in Egypt are infected with genotype 4. To our knowledge there is no enough data about the prevalence of steatosis in genotype 4. The aim of study was to evaluate the prevalence of hepatic steatosis in Egyptian patient with [CHC] genotype 4 and looking for possible correlation with various biochemical and histopathological variables. This study was carried out on 153 patients, with proved chronic hepatitis C [CHC] [positive HCV antibody and HCV RNA], the patients were excluded if they have concomitant hepatitis B infection, liver cell failure, severe renal, heart disease or history of alcohol abuse. Biochemical and histopathological findings were compared between patients with and without hepatic steatosis. Steatosis was found in 73 patients [47.7%], 40 of them [54.8%] had mild steatosis, 21 [28.8%] and 12 [16.4%] had moderate and severe steatosis respectively. No significant differences in level of total serum bilirubin, level of ALT, AST and serum albumin were found among patients with hepatic steatosis and patients without. Histopathological study showed that patients with hepatic steatosis had higher mean fibrotic score and higher mean necroinflammation grading than patients without hepatic steatosis [3.33 +/- 1.49 Vs 2.92 +/- 1.84], [6.96 +/- 2.26 Vs 6.04 +/- 2.64] but with no statistically significant difference. There was no significant statistical differences in the mean age, level of ALT, AST, Serum bilirubin and S. albumin with the increase of grade of steatosis. Steatosis is a feature of CHC Genotype 4 in almost 50% of patients and half of them had moderate to severe steatosis, no significant correlation were found between steatosis and necroinflammatory changes or the meanfibrotic score although steatosis was associated with higher mean necroinflammation score and high mean fibrotic score but without significant statistical difference