Relationship between viral load and steatozis and histological damage in patients with chronic hepatitis C

Hepatitis C is a virus that creates a chronic damage in the liver and causespersistent infection. What makes this illness different and important is not onlythat it causes liver deficiency, hepatocelluler carcinoma (HCC) and requires a newliver by becoming chronic at a high degree but also that it proceeds insidiously,has no clinic symptoms and infectious people create a reservoir in public. Therelation of the chronic Hepatitis C patients? quantitative HCV RNA values andserum transaminase elevation liver histology hasn?t been clearly explained yet.Whether the steatosis seen in the liver causes fibrosis progress or not is not knownyet. The aim of this study is to examine the relation between the values of HCVRNA viral load and ALT, steatosis, histologic activity index and fibrosis in liverand to search whether steatosis contribute the liver fibrosis or not.100 patients, who were diagnosed as chronic hepatitis C but were nottreated, were examined within the research. The patients? HCV RNA and serumALT values were compared with steatosis derived from liver biopsy, necroinflamatureactivity index and fibrosis score.100 patients including 63 women and 37 men got included in the study.The average age was 55.48 ± 11.04 years. Steatosis evaluation was madeaccording to Kleiner. Steatoz staging is evaluated as; <5 % stage 0, 5 %-33 %134stage 1, >33 %-66 % stage 2, >66 % stage 3. % 42 of the patients?s steatosisstaging was established as 0 and % 41 of them was as stage 1 steatoz, % 10 ofthem was stage 2 steatoz, % 7 of them was stage 3 steatosis. Necroinflammatoryactivation index; periportal or periceptal interface hepatit (1-4), confluent necrosis(0-6), focal necrosis, apoptosis and focal inflammation (0-4), portal inflammation(0-4). The Necroinflammatory activation index was evaluated out of 18;according to this 1-4 were assessed as Minimal Chronic Hepatitis, 5-8 LightChronic Hepatitis, 9-13 Medium Activated Chronic Hepatitis, 13-18 HeavyActivated Chronic Hepatitis. As a result of the statistical data, Light ChronicHepatitis C was the most common liver disease with ratio of % 70.7 MinimalChronic Hepatitis C was seen with % 14.1, Medium Activated Chronic HepatitisC % 14.1, and Heavy Activated Chronic Hepatitis C % 1. The fibrosis score ofthe patients are evaluated as 0 fibrosis is absent, 1-2 is light fibrosis, 3-4 ismedium fibrosis, 5-6 is heavy fibrosis. As a result of the statistical data lightfibrosis was the most common fibrosis with the ratio of % 74.7 and mediumfibrosis % 18.2 and heavy fibrosis % 7.1 . In the correlation tests, negativecorrelation was found between HCV-RNA and steatosis. Between HCV RNA andsteatosis, there is a meaningful difference statistically ( p<0.05). HCV-RNA andALT, between the necroinflammatory activation index and fibrosis, there is not asignificant difference statistically. In the correlation tests, a positive correlationwas found among ALT, NIA index and fibrosis and it was accepted statisticallysignificant. (p<0.05). A statistically significant difference could not be foundamong ALT, HCV RNA and steatosis. A statistically significant difference couldnot be found among steatosis, NIA and fibrosis in the correlation tests.The fact that serum ALT stages are the indicators of necroinflammatoryactivation and fibrosis and at the same time the liver damage as well shows thatthe serum ALT levels are important in determining liver biopsy and it could beleading whether there is a need in the treatment of patients with chronic HepatitisC is required or not. Although we found that HCV viral load doesn?t effect liverhistology, future studies are needed to define the liver damage pathogenesis.Steatosis is a common seen histopathological finding in CHC however steatosisdoes not have any effect in the progress of liver fibrosis. More studies, in whichthe relation between fibrosis and steatosis is evaluated, are needed.Key words: HCV RNA viral load, ALT, steatozis, fibrosis