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. 2003 Nov;52(11):1638-43.
doi: 10.1136/gut.52.11.1638.

Liver fibrosis is not associated with steatosis but with necroinflammation in French patients with chronic hepatitis C

T Asselah  1 , N Boyer, M-C Guimont, D Cazals-Hatem, F Tubach, K Nahon, H Daïkha, D Vidaud, M Martinot, M Vidaud, C Degott, D Valla, P Marcellin
Affiliations

Liver fibrosis is not associated with steatosis but with necroinflammation in French patients with chronic hepatitis C

T Asselah et al. Gut. 2003 Nov.

Abstract

Background: In chronic hepatitis C, it has been suggested that steatosis could accelerate progression of fibrosis. However, results of the few published studies are controversial.

Aim: To determine the characteristics (epidemiological, biological, and histological) associated with steatosis and its relationship with liver lesions (grade of necroinflammation and stage of fibrosis) in patients with chronic hepatitis C.

Methods: From November 2000 to July 2001, untreated consecutive adults with chronic hepatitis C admitted for liver biopsy were included in this study. On the day of liver biopsy, a questionnaire for risk factors was completed prospectively, and a blood sample was obtained for laboratory analysis.

Results: Our study included 290 patients (143 men, 147 women). Mean body mass index (BMI) was 24 (3.8) kg/m(2). Proportions of patients with genotypes 1 and 3 were, respectively, 48% and 18%. A total of 135 patients (46.6%) had steatosis. Liver steatosis, in multivariate analysis, was associated with hepatitis C virus genotype 3, higher grade of necroinflammation, and higher BMI. There was no significant association between stage of fibrosis and liver steatosis. In multivariate analysis, high stage of fibrosis was associated with male sex, age over 50 years, high BMI, and high grade of necroinflammation.

Conclusion: In our population of patients with chronic hepatitis C, steatosis does not seem to be an important determinant of liver fibrosis. High grade of necroinflammation is associated with a high stage of fibrosis.

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Figures

Figure 1
Figure 1
Steatosis in chronic hepatitis C. In our population with chronic hepatitis C, we found on the one hand that steatosis was associated with a high body mass index (BMI), high grade of necroinflammation, and genotype 3, and on the other hand that fibrosis was associated with male sex, high BMI, and high grade of necroinflammation. There was no association between steatosis and fibrosis.
See this image and copyright information in PMC

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