The aim of our study was to investigate comparatively the steatotic background in viral
chronic hepatitis B, C and mixed types, in correlation with the severity degree of specific liver lesions. The study group consisted of 1206 liver biopsy specimens, etiologically diagnosed as
hepatitis C - 1021 (84.66%) cases,
hepatitis B - 100 (8.29%) cases,
hepatitis B and
C - 39 (3.23%) cases,
hepatitis B and D - 39 (3.23%) cases,
hepatitis C and toxicity - six (0.49%) cases,
hepatitis B, C and D - one case (0.08%). The histopathological assessment focused on the steatotic lesions associated with
inflammation and
fibrosis. The cases were classified according to
necrosis and inflammatory activity (score between 0-12) and
fibrosis (score between 0-4). Our data indicates significant association of steatotic lesions in
hepatitis C (76.59%) as opposed to other types of viral
hepatitis. In mixed
hepatitis B and C, steatotic lesions are more frequent (66.66%) than in
chronic hepatitis B (47%) and in mixed chronic B and D
hepatitis (48.72%). Steatosis was present in all cases with
chronic hepatitis C and associated toxicity. These observations confirm the important aggressiveness of hepatitis C virus as opposed to
hepatitis B and D virus. The analysis of the pattern of steatosis in correlation with
necrosis and inflammatory activity and
fibrosis, respectively, lead to the identification of certain specific elements. Thus, for all types of
hepatitis, steatosis is associated predominantly with moderate severity (score 6-8) and progressive expansion of
fibrosis (score 2-3). The presence of steatosis does not define hepatic lesions with severe
inflammation (score 9-12) nor those with extended
fibrosis (score 4). The type of steatosis present is mostly macrovesicular, the transformation into
lipid cysts being uncommon. Based on the scoring systems applied in the evaluation of the entire investigated study group, we believe that a possible inclusion of a quantifiable criterion for steatosis could be beneficial in order to complete the characterization of the severity of the lesions, from the point of view of the potential for future evolution, reversible or irreversible.