Aims and objectives
It is well known that hepatitis C virus (HCV),
can lead to steatotic change in hepatocytes.
In fact,
the proportion of chronic hepatitis C patients with steatosis is considerable,
suggesting a direct role of HCV in the intrahepatic accumulation of triglycerides [1,
2].
In addition,
steatosis has been recognized as one of the factors capable of influencing both liver fibrosis progression and the rate of response to interferon–alpha–based therapy [3].
Currently,
percutaneous liver biopsy remains the reference standard for the diagnosis and grading of hepatic...
Methods and materials
Inclusion of patients
This was a prospective,
monocentric,
institutional review board approved study and patient’s enrollment was performed at the Unit of Infectious Diseases of our Institution.
From January 1st,
2013,
through December 31st,
2013,
81 consecutive untreated patients with chronic viral C hepatitis were enrolled into the study after giving written informed consent.
All patients were untreated (i.e.
not under interferon–based therapies) at the time of enrollment.
Exclusion criteria were the presence of major contraindications to 1.5T MRI (e.g.
cardiac pacemaker,
claustrophobia,
foreign bodies...
Results
Four patients were excluded due to severe motion/respiratory artifacts in their MRIs,
precluding an accurate measurement of PDFF.
The resulting cohort of 77 patients with chronic C hepatitis included 43/77 (55.8%) males and 34/77 (44.2%) females with a mean age of 51.31±11.27 (from 18 to 81) years and a mean BMI of 22.39±2.27 (from 18.43 to 27).
Seventy–one/77 patients (92.2%) presented detectable serum HCV–RNA levels (above the detection threshold of 15 IU/mL of our method),
while 6/77 patients (7.8%) were in sustained virological response.
In...
Conclusion
Liver biopsy with histological visualization of hepatocellular fat vacuoles remains the reference method in order to determine the grade of steatosis in chronic liver diseases,
but it is an invasive procedure,
which can study only a small portion of the liver (i.e.
1/50,000 of the total volume) [4,
31].
Discomfort and bleeding are well known procedure–related complications.
In addition to sampling errors,
routine histological examination is semi–quantitative,
observer–dependent,
and grading is performed with broad severity brackets [38].
Therefore,
a non–invasive and objective assessment on a...
References
1: Negro F.
Mechanisms and significance of liver steatosis in hepatitis C virus infection.
World J Gastroenterol.
2006 Nov 14;12(42):6756-65.
Review.
PubMed PMID: 17106922.
2: Asselah T,
Rubbia-Brandt L,
Marcellin P,
Negro F.
Steatosis in chronic hepatitis C: why does it really matter? Gut.
2006 Jan;55(1):123-30.
Review.
PubMed PMID: 16344578; PubMed Central PMCID: PMC1856395.
3: Adinolfi LE,
Gambardella M,
Andreana A,
Tripodi MF,
Utili R,
Ruggiero G.
Steatosis accelerates the progression of liver damage of chronic hepatitis C patients and correlates with specific HCV genotype...