title: Hepatic steatosis and the risk of hepatocellular carcinoma in chronic hepatitis C.
abstract: OBJECTIVE
  Obesity associated hepatic steatosis has been suggested to have a premalignant potential. We determined whether hepatic steatosis predisposes to liver cancer in persons with chronic hepatitis C virus (HCV) infection.
  
  
  METHODS
  We compared the histological severity of steatosis in the index liver biopsies of 25 patients with chronic hepatitis C who subsequently developed hepatocellular carcinoma (HCC) with matched controls who did not. Cases were aged (mean) 54.7 years, 84% males, 76% genotype 1, and 64% fibrosis stage 4; and controls were matched for these characteristics. Those with a sustained virologic response to antiviral therapy were excluded.
  
  
  RESULTS
  Duration of HCV infection, concomitant alcohol intake, body mass index and indices of past hepatitis B virus (HBV) infection were comparable between the groups. Controls were followed for a longer period after the index liver biopsy than were cases (113 months vs 55 months, P < 0.001). As determined by percentage area of biopsy core occupied by steatosis on computer assisted morphometric evaluation, and graded by semiquantitative histological assessment, steatosis was comparable among cases and controls. The odds of developing HCC among those with steatosis grades 1 and 2 did not differ significantly from those without steatosis. There was no association between increasing morphometric percentage area occupied by steatosis and the subsequent development of HCC. Neither steatosis grade or percent area of steatosis on biopsy were selected in multivariate regression analysis as independent predictors for the development of HCC.
  
  
  CONCLUSIONS
  Hepatic steatosis does not augment the risk of hepatocarcinogenesis in patients with chronic HCV infection.
authors.affiliation: Storr Liver Unit, Westmead Millennium Institute, Westmead, New South Wales, Australia.
authors.forename: Dinesh
authors.initials: D
authors.lastname: Kumar
authors.forename: Geoffrey C
authors.initials: GC
authors.lastname: Farrell
authors.forename: James
authors.initials: J
authors.lastname: Kench
authors.forename: Jacob
authors.initials: J
authors.lastname: George
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000209:etiology*; D016022:Case-Control Studies; D005234:Fatty Liver / Q000150:complications*; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008113:Liver Neoplasms / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012306:Risk