Vladimír Bartoš, Pavol Slávik, Ľudovít Lauko, Dušan Krkoška, Renáta Szépeová
Introduction: Chronic hepatitis B (CHB) and C (CHC) are histologically often accompanied by steatosis of hepatic parenchyma, that can be a result of the influence of both, viral and environmental factors. Although this phenomenon is considered to be a negative histomorphological parameter, data about a relationship between steatosis and other pathological changes in these infectious disorders are still controverse. The aim of the study: The aim of our retrospective study was the evaluation of liver steatosis prevalence, and its impact on degree of histological necro-inflammatory activity (grade) and portal fibrosis (stage) in CHB or CHC infected individuals. Material and methods: A set of 121 patients (69 males, 52 females, 37,5 yr. average) with either CHC (n=76) or CHB (n=45) who underwent a core needle liver biopsy during 5-years period (2002-2006) were included in this study. The slight majority of CHB individuals were HBeAg-negative and anti-HBeAg positive. In cases of HCV infection, all patients were HCV RNA and anti-HCV positive, in which HCV genotype type 1 had been predominated. None case of HBV/HCV coinfection was recorded. The biopsy samples were fixed in buffered formalin, embedded in paraffin blocks, stained with hematoxylin-eosin and special histochemical methods and after complete processing examined by two independent pathologists - specialists in hepatology. Histological grading and staging of hepatitis were evaluated according to Ishak’s modified Index Histological Activity (mHAI) criteria, degree of steatosis was classified in 5 groups proposed by Wyatt. Results: In CHC and CHB, steatosis occured in 47 (61,8 %), and 20 (44,4 %) of cases, retrospectively. The most frequent degree of steatosis was 3-10 % in both groups. Microvesicular type predominated in lower degrees (S I, II), macrovesicular type in higher degrees (S III, IV). In CHC, we revealed a significant correlation between a degree of steatosis and histological grade (p=0,006), but not between steatosis and stage (p=0,6). A strong association was also present between steatosis and age of patients (p=0,002). In CHB, we did not reveal a significant relationship of steatosis neither to grade (p=0,4) nor to stage (p=0,5). A correlation between steatosis and age was near to statistical significance (p=0,06). Conclusion: Liver steatosis was a frequent histological findings in both disorders. In HCV-infected patients, we revealed an association between steatosis and necro-inflammatory activity, but not between steatosis and portal fibrosis. In HBV-infected individuals, we did not demonstrate a significant association of the hepatic steatosis neither with a necroinflammatory score, nor with a portal fibrosis. Further studies are warranted to assess the effect of fatty changes on microscopical tissue damage progression in patients with these infectious diseases.