Steatosis in Patients with Genotype 1b Virus C Compensated Liver Cirrhosis

Background: Association of hepatic steatosis with chronic hepatitis C virus infection is a negative prognostic factor for both hepatic diseases. Aim: to study hepatic steatosis association in patients with virus C genotype 1b Child - Pugh A compensated liver cirrhosis. Methods: The prospective study included 158 patients with virus C genotype 1 Child - Pugh A compensated liver cirrhosis (F4 fibrosis) in view of oral antiviral treatment. Steatosis, activity and fibrosis were quantified non-invasively through FIBROMAX. In each patient the following parameters were analysed: age, sex, body mass index (BMI), biological parameters, HCV- RNA level, the presence of esophagial varices, previous treatment with Peginterferon and Ribavirin, comorbidities. Results: Hepatic steatosis was present in 89.2% of the studied patients: mild (31%), moderate (35.4%) and severe (22.8%). Hepatic steatosis correlated statistically significant with advanced age, body mass index, glycemia, triglycerides, ALT, AST, GGTP, alkaline phospatase, bilirubin, necro-inflammatory activity, type 2 diabetes mellitus. There were no significant correlations with sex, cholesterol, platelets, albumin, alphafetoprotein, esophageal varices, HCV- RNA, previous antiviral treatment with Peginterferon and Ribavirine. One third of patients had cardiovascular diseases and the presence of steatosis was noticed in 89.58% of these patients. Conclusions: Almost all patients with genotype 1b virus C compensated liver cirrhosis have hepatic steatosis. The presence of steatosis is associated with metabolic parameters (increased BMI, hypertriglyceridemia, T2DM, cardiovascular pathology) and increased activity of hepatic disease. Management of steatosis can improve the prognosis of virus C hepatic disease; on the other hand sustained virological response - a reality in direct acting antiviral therapy era - can improve metabolic complications of hepatic C virus infection.