My last biopsy showed fatty liver - about 50% of the tissue sample. I was shocked because my last two biopsies specifically said no steatosis. I had gained quite a bit of weight and decided that was the reason for it and was able to get most of the weight off before I started treatment again.
Well the GI Dr I was seeing could not find my genotype. Ran numerous tests. He didn't know what to do so he sent me to a hepatologist at Mercy Hospital. The Dr I saw there was able to find my genotype. I think I am sticking with this Dr. He is chief Dr over the whole liver dept. No one knows why the first tests didn't work. So far I know I am genotype 1. Have stage 2 fibrosis. Viral load at 6.2 million. And fatty liver. And an enlarged spleen.
I was diagnosed with fatty liver one year post SVR and was still shown to have it at 5 years post. Apparently ultrasound is not a very useful tool for determining progression/regression as they weren't able to tell me whether it had gotten better or worse.
Steatosis is generally more common with genotype 3. I see they finally told you that you are geno 1 after months of indeterminate genotype results. Did they ever explain what that was all about?
"The published data suggest that: (1) hepatic steatosis is present in about 50% of patients with HCV infection; (2) the association of HCV and steatosis is genotype-specific; (3) steatosis contributes to the progression of fibrosis in HCV-related liver disease; (4) NAFLD adversely affects the virologic response rates to anti-HCV therapy; and (5) the concomitant presence of NAFLD and HCV infection possibly leads to an increased risk of hepatocellular carcinoma. This all makes sense because there is overlap between the risk factors for progression of fibrosis in HCV-related liver disease and in NAFLD; development of cirrhosis is accelerated by male sex, excess alcohol intake, HIV coinfection, type 2 diabetes mellitus, and obesity."
From "Can Fatty Liver Disease Affect the Prognosis in Patients Who Have Concomitant Chronic Hepatitis C?"
William F. Balistreri, MD 2006
FATTY LIVER
http://emedicine.medscape.com/article/175472-overview#showall
"Fatty liver disease can range from fatty liver alone (steatosis) to fatty liver associated with inflammation (steatohepatitis). This condition can occur with the use of alcohol (alcohol-related fatty liver) or in the absence of alcohol (nonalcoholic fatty liver disease [NAFLD]).
Fatty liver disease is now the most common cause for elevated liver function tests in the United States. This is mainly due to the ongoing obesity epidemic in the United States.
Fatty liver can be associated with the use of alcohol. This may occur with as little as 10 oz of alcohol ingested per week.
**** Identical lesions also can be caused by other diseases or toxins.****
If steatohepatitis is present but a history of alcohol use is not, the condition is termed nonalcoholic steatohepatitis (NASH). Fatty change in the liver results from excessive accumulation of lipids within hepatocytes. Simple fatty liver is believed to be benign, but NASH can progress to cirrhosis and can be associated with hepatocellular carcinoma. The main risk factors for simple fatty liver (NAFLD) and NASH are obesity, diabetes, high triglyceride levels, or a high fat diet.
Fatty liver is the accumulation of triglycerides and other fats in the liver cells. In some patients, this may be accompanied by hepatic inflammation and liver cell death (steatohepatitis).
Potential pathophysiological mechanisms include the following: (1) decreased mitochondrial fatty acid beta-oxidation, (2) increased endogenous fatty acid synthesis or enhanced delivery of fatty acids to the liver, and (3) deficient incorporation or export of triglycerides as very low-density lipoprotein.
United States
Steatosis affects approximately 25-35% of the general population. Steatohepatitis may be related to alcohol-induced hepatic damage or may be unrelated to alcohol (ie, NASH). NASH has been detected in 1.2-9% of patients undergoing routine liver biopsy. NAFLD is found in over 80% of patients who are obese. Over 50% of patients undergoing bariatric surgery have NASH."
Good luck.
Hector
I have exercised all my life and have tried to eat well, no drinking and I have a fatty liver, I was so ashamed. Its pretty common like bill1954 said, he comforted me as well when I first joined the forum :)
Hi Summer,
Fatty liver disease (steatosis) is a relatively common affliction. Wikipedia has a decent article on it here:
http://en.wikipedia.org/wiki/Non-alcoholic_fatty_liver_disease
--Bill