Esteatosis hepática en la hepatitis crónica por virus C: estudio de los factores de riesgo y relación con el estadio de fibrosis

Abstract

Background and objective Liver steatosis (LS) is a frequent histological finding in chronic hepatitis C virus (HCV) infection with prognostic implications. The aim of the present prospective study was to analyse the risk factors of steatosis and its relationship with the fibrosis stage in patients with chronic HCV infection. Material and method Eighty four consecutive HCV RNA positive patients, not treated previously, in whom a liver biopsy was performed, were enrolled. In each patient demographic, clinical, laboratory, viral, and histological variables were obtained at the time of biopsy. Bivariate and multivariate analysis, calculating the odds ratio (OR) and the 95% confidence interval (95%CI), were performed. Results LS was present in 69% of patients. Risk factors of steatosis were an increase of the body mass index (OR: 1.17; 95%CI: 1.01–1.35) and chronic alcohol consumption (OR: 3.58; 95%CI: 1.1–11.6) whereas those of fibrosis were chronic alcohol consumption (OR: 3.58; 95%CI: 1.1–11.6) and increase of the liver inflammatory activity (OR: 1.31; 95%CI: 1.13–1.53). LS was associated with genotype 3 virus infection, which was present in all patients with this infection who had severe steatosis in a significantly greater proportion than in patients with non-genotype 3 virus infection (41.7% vs 2.8%; P<.001). LS was more frequent in patients with advanced fibrosis stages than in patients with non-advanced fibrosis (78,9% vs 60,9%; P=.074). Conclusions LS is a frequent finding in HCV chronic infection related to both host and viral factors. LS could be a worsening factor of hepatic injury.