Steatosis and chronic hepatitis C: analysis of fibrosis and stellate cell activation

Background/Aims: Steatosis is a frequent histological finding in chronic he patitis C and is associated with increased hepatic fibrosis. Methods: We studied 80 patients with untreated chronic hepatitis C to deter mine whether steatosis contributes to fibrosis through a steatohepatitis-li ke pathway. Results: Fine sinusoidal and/or central vein fibrosis was present in 52 pat ients (65%), This was typically located in acinar zone 3 and had a chicken- wire appearance similar to that seen in steatohepatitis. A statistically si gnificant relationship was found between subsinusoidal fibrosis and age (r( s) = 0,33, P = 0.003) and grade of steatosis (r(s) = 0.35, P = 0.001). Mean body mass index was higher in patients with focal (28.4 +/- 4.7 kg/m(2)) o r extensive (29.6 +/- 5.9 kg/m(2)) subsinusoidal fibrosis than in those pat ients with no subsinusoidal fibrosis (25.5 +/- 3.7 kg/m(2)). The extent of or-smooth muscle actin staining (as a marker of stellate cell activation) c orrelated with the degree of portal inflammation and the stage of portal fi brosis, but not with the grade of hepatic steatosis. Conclusions: These findings suggest that in hepatitis C infection, host fac tors, particularly adiposity, contribute to both steatosis and acinar fibro sis.The implication of these observations is that weight reduction may prov ide an important therapeutic strategy for patients with chronic hepatitis C . (C) 2001 European Association for the Study of the Liver. Published by El sevier Science B.V. All rights reserved.