Prevalence of antibodies to hepatitis C virus in patients with nonalcoholic fatty liver.

BACKGROUND

Nonalcoholic fatty liver can be caused by obesity, diabetes mellitus, hyperlipidemia or nonalcoholic steatohepatitis. Hepatitis C viral infection can also cause macrovesicular steatosis and such inflammation of the liver as nonalcoholic steatohepatitis. To determine whether the prevalence of anti-HCV is higher in patients with nonalcoholic fatty liver, this clinical study was undertaken; we also tried to detect which factors predict the presence of anti-HCV in these patients.

METHODS

The study included 205 nonalcoholic fatty liver patients (122 males and 83 females) with a mean age of 46.5 years, diagnosed by ultrasonic examination, on whom anti-HCV antibody tests were then done.

RESULTS

Eleven cases (5.4%) were anti-HCV positive with a higher mean age of 56.4 +/- 11.1 years (p < 0.05). Anti-HCV positive patients had higher serum AST and ALT levels than negative patients (95 +/- 59 U/L, 166 +/- 116 U/L vs. 34 +/- 26 U/L, 51 +/- 43 U/L; p < 0.05), while anti-HCV negative patients had higher mean body weight (124 +/- 15% vs. 114 +/- 11% of IBW) and serum cholesterol levels (202 +/- 41 mg/dl vs. 159 +/- 45 mg/dl). There was no statistical difference between anti-HCV positive and negative groups in clinical parameters including gender, presence of HBsAg, history of DM, operation, blood transfusion, oral contraceptive usage, and cancer with or without chemotherapy. The prevalence of anti-HCV increased with age from 1.8% in the fourth and fifth decades to 25% in the eighth decade. The prevalence of anti-HCV was 1.4% (1 case) in 72 fatty liver with normal biochemical tests and 7.5% (10 cases) in 133 cases with abnormal biochemical tests, a difference which was statistically marginally significant (p = 0.055). Those with ALT levels greater than three-fold the normal limit had a significantly higher anti-HCV prevalence rate (25.9%) than those with normal (1.4%) or mildly (2.8%) elevated ALT levels (p < 0.001). Logistic regression analysis revealed that only age and serum ALT levels were independent predictive factors for the presence of HCV infection.

CONCLUSIONS

Results revealed that the prevalence of anti-HCV in patients with nonalcoholic fatty liver was 5.4%, slightly higher than in the general population. Age and serum ALT level were the predictive factors for the presence of HCV infection.