Search resultsPredictive factors for the severity of liver fibrosis in patients with chronic hepatitis C and moderate alcohol consumption
Title
Predictive factors for the severity of liver fibrosis in patients with chronic hepatitis C and moderate alcohol consumption
Publication type
Journal Article
Year of Publication
2003
Authors
Journal
Romanian Journal of Gastroenterology
Volume
12
Issue
3
Pagination
183 - 187
Date published
2003
ISBN
12214167 (ISSN)
Keywords
Adult, alcohol, alcohol consumption, Alcohol Drinking, article, bile duct injury, cell aggregation, chronic hepatitis, Chronic viral C hepatitis-alcohol, correlation analysis, demography, disease severity, fatty liver, Female, gamma glutamyl transferase blood level, gamma glutamyltransferase, genotype, hepatitis C, Hepatitis C virus, Hepatitis C, Chronic, human, human tissue, Humans, inflammation, Liver, liver biopsy, Liver Cirrhosis, liver fibrosis, lymphoid cell aggregation, major clinical study, male, mean corpuscular volume, Middle Aged, multivariate logistic regression analysis, Prognosis, risk factor, Risk Factors, statistical analysis, Steatosis
Abstract
Background and aims. Among the histological lesions seen in chronic hepatits C (CHC), the presence of steatosis, bile duct lesions and lymphoid aggregates are characteristic. Recent reports suggest that steatosis is an independent risk factor for liver fibrosis in CHC. The aim of our study was to determine the relative contribution of steatosis and moderate alcohol consumption to the severity of liver fibrosis in patients infected with genotype 1 hepatitis C virus. Methods. We evaluated the patients with biopsy proven CHC and no or only moderate alcohol intake (<40g/day). The demographical parameters of the study population, the indices of alcohol consumption: erythrocyte median corpuscular volume (MCV), γ-glutamyl transpeptidase (GGT), the histological characteristics were noted and a statistical analysis was performed in order to determine the factors independently associated with severe fibrosis and with severe steatosis. Results. From the 200 patients included in the study, 82 were males and 118 females, with a mean age of 47.75±10.42 years. At univariate analysis, advanced (grade 2, 3) fibrosis correlated with: the age at the time of biopsy, increased inflammatory activity (HAI), moderate/severe steatosis, alcohol intake, elevated GGT and MCV values. After multivariate logistic regression only age, HAI and steatosis were independently associated with advanced fibrosis stage. Regarding hepatic steatosis, from the factors found to correlate with severe steatosis at univariate analysis (alcohol intake, elevated GGT and MCV levels, severe fibrosis), after multivariate logistic regression only the elevated level of GGT was an independent prognostic factor for severe steatosis. Conclusions. Steatosis is an important risk factor for the severity of liver disease in CHC patients. Among patients with chronic hepatitis C virus infection and moderate alcohol intake, those with serum levels of GGT over two times the normal value are at high risk for severe steatosis.