Effect of steatosis and inflammation on liver fibrosis in chronic hepatitis C

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http://www3.interscience.wiley.com/journal/120126019/abstract?CRETRY=1 & SRETRY=0

Liver International

Volume 29 Issue 2, Pages 153 - 158

Published Online: 15 May 2008

The Official Journal of the International Association for the Study of the Liver

CLINICAL STUDIES

Effect of steatosis and inflammation on liver fibrosis in chronic hepatitis C

Urpo Nieminen 1 , Perttu E. T. Arkkila 1 , Päivi Kärkkäinen 2 and Martti A.

Färkkilä 1

1 Department of Medicine, Division of Gastroenterology, Helsinki University

Central Hospital, Helsinki, Finland

2 Department of Pathology, Helsinki University Central Hospital, Helsinki,

Finland

Correspondence

Urpo Nieminen, MD, PhD, Department of Medicine, Division of Gastroenterology,

Helsinki University Central Hospital, Haartmaninkatu 4, PO Box 340, 00290

Helsinki, Finland

Tel: +358 50 427 1623

Fax: +358 9 4717 4688

e-mail: urpo.nieminen@...

ABSTRACT

Background/Aims: 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.

Patients/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.

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Received 6 January 2008

Accepted 30 March 2008

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1478-3231.2008.01779.x