Steatosis and bile duct damage in chronic hepatitis C: distribution and relationships in a group of Northern Italian patients

Background/Aims: Hepatitis C virus (HCV) related disease follows a long, be nign course and most affected patients have mild disease. Liver biopsy is m andatory to grade and stage the disease. Characteristic, though non-specifi c, HCV histological lesions such as bile duct damage and steatosis have bee n singled out but their association with non-histological parameters has no t been completely defined. Our aim was to study the relationships among the se histological lesions and clinical, biochemical, functional and virologic al characteristics in a group of Northern Italian patients with chronic hep atitis. Methods: We studied 172 patients with HCV-related chronic hepatitis . Patients were divided into groups on the basis of histology including bil e duct damage and steatosis. Clinical, biochemical, functional and virologi cal profiles were related to histological findings. Results: Histological g rading and staging of disease increased as the age of patients increased. S teatosis was present in 70% of our patients and was related to a higher deg ree of fibrosis and to decreased functional activity. The prevalence of bil e duct damage was 20%. This lesion was present in older patients with highe r staging and impaired liver function. Biochemically it was associated with an increase in aspartate aminotransferase, gammaglutamyltranspeptidase, al kaline phosphatase, and total bilirubin. Conclusions: In the population we studied, HCV chronic hepatitis was predominantly a mild disease. Moreover b oth steatosis and bile duct damage were also mild. Steatosis was associated with fibrosis and this might influence liver metabolic function. Bile duct lesions were found in older patients with advanced disease showing biochem ical evidence of cholestasis. The molecular role HCV might play in the path ogenesis of these histological features should be addressed in further stud ies.