الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Chronic hepatitis C is defined as infection with the hepatitis C virus persisting for more than six months. Clinically, it is often asymptomatic and it is mostly discovered accidentally.
Many patients with chronic HCV are also noted to have a degree of steatosis present on their liver biopsies. Hepatic steatosis is defined as excessive lipid accumulation within the hepatocyte cytoplasm and has been more recently recognized as a significant cause for cirrhosis in the United States.
The aim of the present study is to correlate the occurrence and severity of liver steatosis with HCV RNA genotype, viral load, and previously recognized risk factors for steatosis (hyperlipedemia and obesity) in children with chronic hepatitis C virus infection.
In our study we made thorough examination and investigations to 125 CHC patients attending the hepatology clinic at Alexandria University Children’s Hospital. The inclusion criteria were as follows: age between 5-15 years, Patients had 2 positive PCR tests for HCV RNA at least 6 months apart and they had liver biopsy previously done.
All patients had negative tests for hepatitis B surface antigen and HIV antibodies. None of them were under interferon alpha therapy. Patients with hepatic decompensation were excluded. Patients with other causes of chronic liver diseases such as autoimmune hepatitis, genetic liver disease and exposure to hepatotoxic drugs were excluded.
In our study, the prevalence of histological evidence of hepatic steatosis found in our CHC children is 17.6%. Steatosis was mild in 62% patients, and moderate in the remaining 38% patients. None of the patients had severe steatosis.
CHC children with and without steatosis had same grade of necro-inflammation and stage of fibrosis on liver biopsy. We found no relationship between steatosis and activity of necro-inflammation in liver histology.
There was a statistically significant association between NS and steatosis, as well as, between BMI and steatosis. Children with nephrotic syndrome and CHC are more liable to have steatosis 5.46 times more than children with CHC alone.
BMI was a fair predictor for hepatic steatosis in children according to logistic regression analysis, while high cholesterol level is a weak predictor for hepatic steatosis in children according to logistic regression analysis.
The developed model depending on BMI and cholesterol level is considered fair in predicting hepatic steatosis in children with CHC infection (better than BMI alone).
No correlation was found between presence and severity of steatosis and viral load among Egyptian children (CHC-genotype 4).