Effect of steatosis and inflammation on liver fibrosis in chronic hepatitis C.
OBJECTIVE
The role of liver biopsy has been questioned in the management of patients with hepatitis C viral (HCV) infection. The aims of this study were to determine the impact of clinical parameters and degree of inflammation and steatosis on liver fibrosis.


METHODS
Clinical data and liver histology findings in 510 HCV patients were analysed.


RESULTS
Hepatitis C virus genotype 1 (GT-1) was found in 38%, GT-2 in 15% and GT-3 in 45% of patients. In liver biopsy specimens, inflammation activity was present in 68%, increased fibrosis in 19% and marked steatosis in 17% of patients. Independent clinical risk factors for the increased fibrosis were patients' age at biopsy, body mass index (BMI) and duration of HCV. Steatosis and inflammation activity were independent histological risk factors for fibrosis only in GT-1; in GT-3, only inflammation correlated independently with fibrosis.


CONCLUSIONS
Age at liver biopsy, BMI and duration of HCV were independent risk factors for increased fibrosis in HCV patients. Steatosis as a risk factor for fibrosis is evident in GT-1. When scoring liver biopsies of HCV patients, the degree of steatosis should be included in addition to fibrosis and inflammation activity.
Nieminen
Urpo
U
Department of Medicine, Division of Gastroenterology, Helsinki University Central Hospital, Helsinki, Finland.
Arkkila
Perttu E T
PE
Kärkkäinen
Päivi
P
Färkkilä
Martti A
MA
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001706:Biopsy; D015992:Body Mass Index; D005234:Fatty Liver / Q000209:etiology / Q000473:pathology*; D005260:Female; D005387:Finland; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D006526:Hepatitis C / Q000150:complications* / Q000235:genetics; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000473:pathology; D008103:Liver Cirrhosis / Q000209:etiology / Q000473:pathology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors