Evaluation of relation among lipid parameters of sera, liver histopatology and viral load in patients with chronic hepatitis C

Chronic hepatitis C (CHC) is an inflammatory liver disease which is caused by hepatit C virus (HCV). More than half of the HCV infections are going to be chronic. A lot of factors of patient and disease are responsible for the fibrosise growth of chroniced disease. One of this factors is known as liver steatosis. The purpose of this study is to search liver steatosis and the effects of blood lipid parameters, which is one of the important indicator of steatosis, for the fibrosis and necroinflammation that occurs at liver which is caused by CHC. Furthermore, lipid parameters of sera and host factors is aimed to show the rate of relation with liver histopathology.The records of 102 patients with CHC who had not previously been treated with antiviral therapy were retrospectively reviewed between 2006-2008 in Infectious Diseases deparment of Gaziantep University Medical Faculty. The liver biopsies of these patients have been scored in terms of necroinflammation, fibrosis, steatosis with the method of ISHAK by only one patholog. The patients simultaneous total cholesterol (TK), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkalen phosphatase (ALP), gamma glutamyl transpeptidase (GGT), ferritin, platelet (plt), leukocyte, sedimentation, hemoglobin (Hb), hematocrit (Htc), protrombine time (PT), active partial tromboplastine time (aPTT), total protein, albumine, alpha-fetoprotein (AFP) in the sera, host factors (body mass index (BMI), age, sex, occupation) have been scanned retrospectively. The relation between all parameters and stetosis score has been evaluated.In the histopathological evaluation of liver biopsy samples, steatosis has been found in 75 patients (73%). A significant relation has been found among steatosis, histological activity index (HAI) and fibrosis degree (p=0.000, p=0.001). Fibrosis and HAI degrees were examined higher in patients with severe steatosis. There was no significant relation among the values of TG, TC, HDL, LDL, VLDL which were defined as blood lipid profiles and steatosis (p=0.23, p=0.92, p=0.26, p=0.67, p=0.23). Blood lipid profile was not as significant as liver steatosis in detecting progression to fibrosis and necroinflammation. A significant relation between liver steatosis and BMI has been found. A significant relation had been found between steatosis and BMI. Steatosis was seen more frequently in females. It seems the fact that a patient with CHC having liver steatosis has an important role in necroinflammation and fibrosis improvement. The best indicator of steatosis has been showed as BMI. It was estimated that blood lipid profile was not significant in demonstrating steatosis.