Alcohol is an important co-factor for both steatosis and fibrosis in Northern Italian patients with chronic hepatitis C.
OBJECTIVE
Steatosis in patients with chronic hepatitis C (CHC) may be the result of both viral and host factors. To evaluate: (1) the relationship between steatosis and either host or viral factors; (2) the correlation between steatosis and fibrosis in patients with CHC.


METHODS
A consecutive series of 349 patients were evaluated for steatosis. At liver biopsy, patients were tested for virological, and laboratory analysis and questioned for alcohol consumption.


RESULTS
Logistic regression analysis demonstrated that steatosis was independently associated with genotype 3a (odds ratio, OR 3.5), alcohol intake at the time of biopsy (OR 2.6) and age >35 years (OR 2.7). In multivariate analysis the presence of fibrosis was associated with past alcohol abuse (OR 3.7), and age older than 44 years (OR 2.2). Overall, a weak correlation was found between grade of steatosis and fibrosis score (r=0.861, P=0.05), which disappeared excluding patients without past or current alcohol intake. A direct correlation emerged between grade of steatosis and both 'grading' and 'staging' only in patients with genotypes other than 3a.


CONCLUSIONS
Genotype 3a is the main risk factor for steatosis in patients with CHC. The grade of steatosis correlated with both grading and staging only in patients with genotypes other than 3a and this relationship is strictly linked to alcohol consumption.
Fabris
Paolo
P
Department of Infectious Diseases and Tropical Medicine, S. Bortolo Hospital, Viale Rodolfi 37, Vicenza, Italy. pfabris@yahoo.com
Floreani
Annarosa
A
Carlotto
Antonio
A
Giordani
Maria Teresa
MT
Baldo
Vincenzo
V
Stecca
Clara
C
Marchioro
Lorella
L
Tramarin
Andrea
A
Bertin
Tosca
T
Negro
Francesco
F
de Lalla
Fausto
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D000437:Alcoholism / Q000150:complications; D005234:Fatty Liver / Q000209:etiology* / Q000473:pathology / Q000821:virology; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000473:pathology / Q000821:virology; D006801:Humans; D007558:Italy; D008103:Liver Cirrhosis / Q000209:etiology* / Q000821:virology; D016015:Logistic Models; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D015999:Multivariate Analysis