Minakari Mohammad, Sameni Farzaneh Khadem, Shalmani Hamid Mohaghegh, Molaee Mahsa, Zali Mohammad-Reza
Department of Gastroenterology, Isfahan University of Medical Sciences, Isfahan, Iran.
Med Princ Pract. 2008;17(2):126-30. doi: 10.1159/000112966. Epub 2008 Feb 19.
To evaluate the frequency and severity of fibrosis, and also the association of various viral and host factors of steatosis in Iranian patients with hepatitis C (CHC).
Eighty treatment-naive CHC patients, age 37.6 +/- 11.77 years, were studied. Percutaneous liver biopsy was performed for all patients. Based on pathology reports, patients were divided into two groups: with and without significant steatosis. Hepatitis C virus RNA (HCV-RNA), various viral and host factors, and biochemical findings and genotyping of HCV were compared in the two groups.
Of the 80 patients, 42 (52.5%) had pathologic evidence of significant steatosis. The mean serum level of cholesterol, triglyceride, glucose, and gamma-glutamyl transpeptidase as well as the mean body mass index, viral load, stage of fibrosis and frequency of genotype 3 were significantly higher in the patients with than those without steatosis (p < 0.05). In multivariate analysis, only genotype 3 and viral load had significant association with steatosis. In patients with genotype 3 infection, the mean viral load in those with and without steatosis was 1,623,357 +/- 833,543.46 and 821,262.1 +/- 924,480 copies/ml, respectively, and the difference was statistically significant (p = 0.009). The mean viral load in patients with genotype 1 infection was not significantly different between the two groups. The mean stage of fibrosis was higher in the group that had significant steatosis (p < 0.05).
Steatosis is a common finding in Iranian patients with CHC. Infection with HCV genotype 3 and high viral load in these patients are associated with significant steatosis.
评估伊朗丙型肝炎(CHC)患者肝纤维化的发生率和严重程度,以及各种病毒和宿主因素与脂肪变性的关联。
对80例未经治疗的CHC患者进行研究,患者年龄为37.6±11.77岁。所有患者均接受经皮肝穿刺活检。根据病理报告,将患者分为两组:有显著脂肪变性和无显著脂肪变性。比较两组患者的丙型肝炎病毒RNA(HCV-RNA)、各种病毒和宿主因素、生化检查结果以及HCV基因分型。
80例患者中,42例(52.5%)有显著脂肪变性的病理证据。有脂肪变性患者的血清胆固醇、甘油三酯、葡萄糖和γ-谷氨酰转肽酶平均水平以及平均体重指数、病毒载量、纤维化分期和3型基因型频率均显著高于无脂肪变性患者(p<0.05)。多因素分析显示,仅3型基因型和病毒载量与脂肪变性显著相关。在3型基因型感染患者中,有和无脂肪变性患者的平均病毒载量分别为1,623,357±833,543.46和821,262.1±924,480拷贝/ml,差异有统计学意义(p = 0.009)。1型基因型感染患者两组间平均病毒载量无显著差异。有显著脂肪变性组的平均纤维化分期更高(p<0.05)。
脂肪变性在伊朗CHC患者中常见。这些患者感染HCV 3型基因型和高病毒载量与显著脂肪变性相关。