Steatosis accelerates fibrosis development over time in hepatitis C virus genotype 3 infected patients.
OBJECTIVE
Steatosis is common in patients with hepatitis C virus (HCV) infection. Its influence on disease progression is only partially understood. The aim of this study was to evaluate the impact of steatosis on fibrosis progression over time in relation to HCV genotype.


METHODS
We retrospectively analyzed 98 patients who underwent dual liver biopsies prior to antiviral treatment. The median follow-up time was 5.8 years. Biopsy specimens were assessed for necroinflammatory activity, fibrosis and steatosis.


RESULTS
The prevalence and grade of steatosis were strongly associated with HCV genotype 3, independent of sex, age, body mass index and alcohol consumption. Progressive fibrosis was more prevalent in patients whose initial biopsy showed steatosis, an effect seen mainly in genotype 3 infected patients. Low-grade steatosis was observed in overweight patients, but high-grade steatosis was associated with genotype 3, independent of body mass index.


CONCLUSIONS
Our data confirm the association between HCV genotype 3 and steatosis. Furthermore, we showed that steatosis in genotype 3 infected patients is a risk factor for progression of fibrosis. Therefore, patients with genotype 3 and steatosis ought to be recommended for early therapeutic intervention.
Westin
Johan
J
Department of Infectious Diseases, Sahlgrenska University Hospital/Ostra, Göteborg University, SE-416 85 Göteborg, Sweden. johan.westin@infect.gu.se
Nordlinder
Hans
H
Lagging
Martin
M
Norkrans
Gunnar
G
Wejstål
Rune
R
D000328:Adult; D018450:Disease Progression; D005234:Fatty Liver / Q000453:epidemiology / Q000209:etiology / Q000473:pathology / Q000821:virology*; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D006526:Hepatitis C / Q000150:complications* / Q000235:genetics / Q000473:pathology*; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D015995:Prevalence; D013997:Time Factors