Authors: Bolaños Nantli, Cerda Eira, Sanchez Anahi.
Introduction: MAFLD is a metabolic fatty liver disease not associated with alcohol or other liver disease, which is characterized by a finding of greater than 5% of hepatic steatosis associated with metabolic syndrome criteria. It is an asymptomatic disease, with a wide spectrum of diseases ranging from fibrosis to cancer, which is currently on the rise in Western life. HCV infection is currently curable with DAAs, and depending on the time at which it is treated, liver damage can be definitively halted. Therefore, based on the updated MAFLD concept, it would be important to know the coexistence of both pathologies and to measure liver damage with their respective complications, in order to stop them in time.
Objective: To determine the implication on the morbidity and mortality of MAFLD in patients with HCV infection in SVR who received treatment with ADD, at the Central Military Hospital in a period from 2016-2019.
Methods: It is an observational, descriptive, retrospective and cross-sectional study, the patients who presented cirrhosis (84) and those who did not (51) were classified into 3 groups: MAFLD, HCV, MAFLD+HCV, to correlate with the demographic data obtained and by the Kruskal-Wallis test to compare Fib4 in non-cirrhotic patients, and MELD and Child Pugh in cirrhotic patients.
Results: In patients without cirrhosis, we were able to document that the degree of fibrosis is statistically significantly higher in HCV patients (p 0.015) compared to MAFLD patients, and slightly higher in the HCV+ MAFLD group. Contrary to what we would expect from the presence of dyslipidemia in the HCV group, it was higher in the HCV+ MAFLD group. In patients with cirrhosis, we could see that there is no statistically significant difference in the degrees of fibrosis between the three groups. There is a greater presentation of dyslipidemia in the MAFLD group, with a lower presentation in the HCV group, and there is also a statistically significant difference in the prognosis of the MAFLD group evaluated with Child Pugh and MELD (p<0.001), being worse in the MAFLD group.
Conclusions: MAFLD is a common disease that every clinician should be aware of in order to be able to treat when it is still reversible and avoid liver involvement, which can even have a worse outcome than HCV infection or HCV+ MAFLD, which otherwise will result in higher health costs, emphasizing that these diseases depend heavily on the habits of patients and that they are within the reach of anyone to prevent irreversible situations.
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