Worsening of steatosis and fibrosis progression

Abstract
We read with great interest the article by Castera and colleagues ( Gut 2003; 52 :288–92) and acknowledge the finding that worsening of steatosis in chronic hepatitis C is associated with fibrosis progression. However, in our view there are no data supporting a casual role for this statistical association or any specific relation of this finding to chronic hepatitis C. Firstly, the authors provide no explanation as to why steatosis worsened in patients under consideration. Overweight, diabetes, and alcohol consumption are the main causes of steatosis in Western countries and major causes of fibrotic liver disease. There are no data throughout the study indicating whether patients in whom steatosis worsened simply gained weight or developed any …