Correlation of steatosis with fibrosis and necro-inflammation in chronic hepatitis C infection in the absence of confounding factors

Abstract

Objective: To assess the frequency and degree of hepatic steatosis in patients of chronic hepatitis C infection and determine its correlation with stages of fibrosis and necro-inflammatory grades.

Study design: Cross-sectional study.

Place and duration of study: The study was carried out in the Department of Pathology (Histopathology), Army Medical College, Rawalpindi, from March 2006 to March 2007.

Methodology: Patients who had undergone a liver biopsy for evaluation of hepatitis C virus infection were included in the study. Demographic characteristics and laboratory data were collected at the time of biopsy. First hundred biopsy specimens meeting the inclusion criteria were assessed for steatosis, necro-inflammation and fibrosis.

Results: Steatosis was present in 46 patients and graded as mild (41.3%), moderate (54.3%) and severe (4.3%). An overall significant correlation was found between grades of steatosis with stage of fibrosis (p < 0.0001) but no correlation was found with necro-inflammatory grades. Only focal necrosis revealed weak correlation with grades of steatosis (p < 0.003).

Conclusion: These results suggest a possible role of the hepatitis C virus itself in the pathogenesis of steatosis and indicate its close relationship with fibrosis and focal degeneration in chronic hepatitis C. Necro-inflammation seen in liver biopsy is host immune reaction to hepatitis C virus and is not related to steatosis.