الفهرس 
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Abstract
Summary
Hepatitis C virus (HCV) infection is one of the main causes of chronic liver disease worldwide.
Egypt has by far the largest hepatitis C virus (HCV) prevalence in the world with 14.7% of the population being antibody positive for HCV
Steatosis is a frequent histological feature in patients chronically infected with hepatitis C virus .There are two main types of steatosis in patients with hepatitis, a metabolic type of steatosis associated with a high body mass index, hyperlipidaemia and insulin resistance and a virally induced form of steatosis.
Patients infected with HCV genotype 3 have a higher prevalence and more sever steatosis than those infected with other genotypes, because the HCV core protein interferes with lipoprotein assembly and secretion. In addition, steatosis is associated with other risks for fatty liver disease as increased body mass index, ethanol use and overweight patients who have high grade seatosis regardless of viral genotype
Several studies have correlated between the presence of steatosis and the presence and progression of fibrosis .Thus, assessing steatosis in liver biopsy is recommended because it may have clinical consequences in hepatitis C.
In a trial to understand relation between steatosis and its relation to the necroinflammatory activity and hepatic fibrosis in Egyptian patients infected with genotype(4) HCV - retrospective study of selected 56 cases of chronic hepatitis C collected from Early Cancer Detection Unit(ECDU), Pathology Department, Faculty of Medicine, Benha University was carried.
Cases were graded and staged according to the modified HAI scoring system and the French METAVIR scoring system.
In the studied cases ,the most common necro-inflammatory grade was moderate and the most common fibrosis stage was stage (F2).
In the current study, steatosis was present in all cases(100%) ,the most common steatosis grade was grade( 2) .The grade of steatosis exhibits statistically significant positive correlation with stage of fibrosis(p <0.05).
Distribution of steatosis in studied cases was commonly periportal with midzonal and pansteatosis.It showed statistically significant positive correlation with necro-inflammatory activity (p <0.05) but insignificant with stage of fibrosis.
Morphometry of steatosis was done , macrovesicular was predominant in studied chronic hepatitis C patients ,showed statistically significant positive correlation with the stage of fibrosis(p <0.05) and was insignificant with necro-inflammatory activity.
To detect fibrosis ,Masson Trichrome and Sirius Red special stains were used .No difference in scoring was detected, but Sirius Red was easily prepared ,less expensive and less time consuming ,so it it recommended to be used.