[Steatosis in chronic viral hepatitis C: frequency, risk factors and relationship with fibrosis].

AIMS: To evaluate the frequency and the severity of hepatic steatosis in chronic hepatitis C patients, to identify the associated factors with the presence of steatosis and to determine the relationship between the presence of steatosis and severity of hepatic fibrosis. METHODS: Lecture of hepatic biopsies was performed blindly by the same histopathologist, using the METAVIR grading. Hepatic steatosis was graded as macrovacuolar or microvesicular. Steatosis was considered as mild, moderate and severe if involving less than 10%, between 10 and 30% and more than 30% of hepatocytes respectively. RESULTS: One hundred and nine patients were studied. Determination of the virus genotype was performed in 59 patients, with 93% of genotype 1. Significant fibrosis was noted in 72 patients (66%). Hepatic steatosis was detected in 53 cases (49%): Mild in 32 cases (30%), moderate in 9 cases (8%) and severe in 12 cases (11%). In univariate analysis, associated factors with steatosis are age more than 50 years, weight more than 65 kg, body mass index more than 25 kg/m2, ASAT levels more than 80 UI/l and ALAT levels more than 100 UI/l. In multivariate analysis, only body mass index more than 25 kg/m2 is associated with the presence of steatosis (p=0.02 OR [95%CI]: 3.37 [1.19-9.53]). Significant fibrosis was more frequently detected in patients with steatosis compared to patients without steatosis (42/53: 80% vs 30/56: 54%; p=0.004). CONCLUSION: Hepatic steatosis is frequent in chronic viral hepatitis C. In our Tunisian population, steatosis is associated with body mass index and not with virological factors.