Liver steatosis in chronic hepatitis C:: a morphological sign suggesting infection with HCV genotype 3

Aims: To identify factors associated with liver steatosis in chronic hepatitis C. Methods and results: Occurrence and severity of liver steatosis in 254 chronic hepatitis C patients were compared with presence of alcohol abuse, body mass index (BMI) >26, history of intravenous drug addiction and hepatitis C virus (HCV) genotype. Steatosis was found in 109 (43%) patients. The occurrence of steatosis was significantly associated with ongoing alcohol abuse (P = 0.03) or HCV genotype 3 (P = 0.003), but not with BMI >26. A moderate to severe steatosis was present in 60% of patients infected with HCV genotype 3, irrespective of the presence of alcohol abuse, BMI >26 or history of intravenous drug addiction. Using a multivariable stepwise logistic regression analysis, infection with genotype 3 had an odds ratio (OR) of 10 (95% confidence interval (CI) = 4.56-22) for a liver steatosis, whereas the presence of a cirrhosis at histology had an OR = 0.256 (95% CI = 0.07-0.92). Conclusions: A moderate to severe degree of steatosis of the liver is a morphological sign suggestive of infection with HCV genotype 3, independent of other risk factors of a fatty liver, but it may disappear at late stages of the disease.