Prevalence and Predictive Factors of Liver Steatosis Evaluated by CAP in Chronic Viral Hepatitis Infected Patients

Introduction: The CAP (Controlled Attenuation Parameter) function of FibroScan® is a new non-invasive diagnostic tool that allows the quantification of liver steatosis at the same time as elastometry. It is based on the attenuation of ultrasound waves. Its use is particularly validated in chronic viral hepatitis.

Objectives: evaluate the frequency and the predictive factors of liver steatosis diagnosed by CAP in a cohort of patients with chronic viral hepatitis submitted to transient elastography by Fibroscan ®.

Methods: This was a retrospective single center study conducted from May 2019 to May 2023. Were included all patients with chronic viral hepatitis B or C who had transient elastography performed with CAP by Fibroscan ®.

Results : Among 636 patients who had a Fibroscan ®, 305 had chronic viral hepatitis: 204 (32%) HVB and 131 (20,5%) HVC.

Mean age was 55±9 years and 55,2% of patients were female. 30% of our patients were obese and 33.5% were overweight. 20,1% of our patients had diabetes, 25,8% had hypertension and 9,3% had dyslipidemia.

The mean CAP value (±SD) was 230,5 dB/m with a corresponding mean liver elasticity of 9.1 kPA. Liver steatosis was found in 38,8% of our patients.

49% of patients with chronic hepatitis C had steatosis on Fibroscan, 32% of those with chronic hepatitis B.

CAP values were significantly correlated with body mass index (p < 0.001), dyslipidemia (p < 0.010) and the presence of steatosis on ultrasound (p < 0.012). In contrast, there was no correlation between CAP values and age, sex, or the existence of diabetes or hypertension.

Conclusion: Fibroscan CAP function detected liver steatosis in 38,8% of patient with viral hepatitis, which was strongly associated with host metabolic factors, e.g., obesity and dyslipidemia. These cofactors may contribute to the progression of liver disease. Thus, they require serious management concomitantly with antiviral therapy.