Assessment of histological features of changes in lipid metabolism in chronic hepatitis C

Introduction: Several data suggest interactions between HCV and lipid metabolism. Nevertheless steatosis is a frequent histological lesion in CH-C, this phenomenon was not analyze as an integral part of the grade in the modified Knodell scoring system.

Aim of this study was to assess relationship between degree of steatosis and serum lipid levels in CH-C patients in correlation with the histological picture.

Patients and methods: 137 CH-C patients were studied and compared to patients with steatosis of other reasons and negative for HCV. Steatosis was graded semiquantitatively. Alanine aminotransferase (ALT) activity, total cholesterol and trigliceride concentrations, presence of HCV RNA were measured in sera of patients. Statistical analysis was performed by one way ANOVA.

Results: Steatosis was detected in 85 CH-C specimens (62%). ALT levels were significantly higher in patients with grade 3 steatosis in the CH-C group, compared to grade 0 steatosis with CH-C (p<0,01). Total cholesterol and trigliceride concentracions were significantly higher (p<0,0001) in patients with steatosis only than in patients with CH-C with or without steatosis. Inserted the degree of steatosis (grade: 0–3) as a fourth character of the grade of the inflammatory process, there was significant correlation between the ALT level and grade of the inflammatory activity in CH-C patients not only in the group without steatosis, but in CH-C patients with steatosis too.

Conclusion: Steatosis in CH-C patients is associated with a significant decrease of cholesterol and trigliceride levels compared to patients with steatosis only. The degree of steatosis is an integral part of the morphological lesions in the liver biopsy.