Steatosis and Fibrosis

The Editors at Hepatitis Central

May 16, 2005

Reading selectively in this article gives us this tidbit: “Age, ADD, diabetes and increase of ALT seem to be the only independent factors associated with liver fibrosis progression.” Among other things, this demonstrates the importance of keeping ALT levels as reduced as possible.

No Correlation Found Between Steatosis and Liver Fibrosis in HCV Genotype 1 Infection

Liver steatosis is generally regarded as a risk factor for chronic liver disease. Moreover, steatosis is considered in HCV-related chronic active hepatitis (CAH) as an adjunctive factor of progression and evolution of liver disease. In particular, steatosis is thought to be specifically related to the course of the disease in genotype 3a patients with CAH.

The aim of this study was to test the role of steatosis in liver damage (fibrosis) in a consecutive case-study of genotype 1b patients who have undergone liver biopsy because of an increase of serum ALT.

180 patients ( sex: M98/F82; median age: 51 range 17 – 68) underwent ultrasound examination and liver biopsy. Based on liver histology patients were divided according to steatosis into four classes: 1 (no steatosis), 2 (steatosis < 30%), 3 (steatosis 30 – 50 %), 4 (steatosis > 50 %).

Results:

Histological Activity Index (HAI) was evaluated according to ISHAK’ s score.
Median fibrosis value was S 2 (ranging 0 – 6; 23 patients showed liver cirrhosis) in all the 4 classes and no statistical significance was found between groups.
Virological and epidemiologic characteristics, biochemical data, BMI, Apparent Duration of Disease (ADD) of all patients were recorded and statistical correlation checked.
A univariate and multivariate analysis vs fibrosis were performed in all the patients and tested statistically significant only for age, ADD, diabetes and ALT (p< 0.00), but not for steatosis.

Conclusion

The authors conclude, “Steatosis does not seem to be an independent adjunctive risk factor of liver disease progression in CAH/genotype 1b HCV-infected patients….Age, ADD, diabetes and increase of ALT seem to be the only independent factors associated with liver fibrosis progression.”

05/02/05

Reference
M Persico and others. NO CORRELATION BETWEEN FAT LIVER ACCUMULATION AND LIVER FIBROSIS IN GENOTYPE 1B HCV RELATED CHRONIC LIVER DISEASE. Abstract 593. 40th EASL. April 13-17, 2005. Paris, France.

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Steatosis and Fibrosis