::INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES::

CODEN : IAJPBB
issn 2349-7750

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TITLE:

EFFECT AND ETIOLOGY OF HEPATIC STEATOSIS IN PAKISTAN: IMPORTANCE OF GENOTYPE 3 HEPATITIS C VIRUS INFECTION

AUTHORS:

Dr Muhammad Saqib Manzoor, Dr Ehsan Ur Rehman, Dr Muhammad Bilal

ABSTRACT:

Introduction: Fatty liver has become an important histological symptom in patients with hepatic dysfunction. It may be an important factor in the progression of hepatitis C virus associated liver disease, particularly in genotype 3 infections. Aims: To determine the etiology and impact of hepatic steatosis in our patients with chronic hepatitis. Place and Duration: In the Pathology and Gastroenterology department of Jinnah Hospital Lahore for one-year duration from May 2019 to May 2020. Methods: All liver biopsies performed in our hospital were analyzed by one pathologist using the results of the histological activity index (HAI) and Brunt's grading for steatosis. Patients were assessed for factors related to steatosis, including the presence of HCV. Results: The biopsies of 439 patients (284 men, mean age 38.5 ± 11.2 years) were examined. Fatty liver was found in 324 (73.8%) biopsies. It was mild in 190/439 (43.3%), moderate in 88/439 (20%) and severe in 46/439 (10.5%) cases. In a one-way analysis, steatosis was associated with HCV infection (p = 0.023), BMI> 25 (p = 0.008), and elevated ALT (p = 0.003), but not with diabetes mellitus, hypertriglyceridemia, HBV infection, or alcohol consumption. In multiple logistic regression, HCV and BMI> 25 were independent risk factors for steatosis. There was a linearly increasing relationship between fatty liver disease and the degree and severity of liver disease (p ≤ 0.001). Of the 369 HCV patients, 280 (76%) had steatosis. It was mild in 159/369 (43%), moderate in 82/369 (22.2%) and severe in 39/369 (10.6%) cases. There were only 32 non-alcoholic patients without viral hepatitis, and 8/32 (25%) had moderate to severe steatosis. Conclusions: Significant fatty liver occurs in 30.5% of our patients with chronic hepatitis. HCV infection with genotype 3 is the main causative agent of fatty liver in Pakistan. Steatosis has a linearly increasing correlation with hepatitis and fibrosis. Key words: fatty liver, hepatitis C virus, body mass index