Steatosis in patients with chronic hepatitis C (CHC) may be the result of both viral and host factors. To evaluate: (1) the relationship between steatosis and either host or viral factors; (2) the correlation between steatosis and fibrosi s in patientswith CHC. A consecutive series of 349 patients were evaluated for s teatosis. At liver biopsy, patients were tested for virological, and laboratory analysis and questioned for alcohol consumption. Logistic regression analysis de monstrated that steatosis was independently associated with genotype 3a (odds ra tio, OR 3.5), alcohol intake at the time of biopsy (OR 2.6) and age >35 years (O R 2.7). In multivariate analysis the presence of fibrosis was associated with pa st alcohol abuse (OR 3.7), and age older than 44 years (OR 2.2). Overall, a weak correlation was found between grade of steatosis and fibrosis score (r=0.861, P =0.05), which disappeared excluding patients without past or current alcohol int ake. A direct correlation emerged between grade of steatosis and both ‘grading ’and ‘staging’only in patients with genotypes other than 3a. Genotype 3a is t hemain risk factor for steatosis in patientswith CHC. The grade of steatosis cor related with both grading and staging only in patients with genotypes other than 3a and this relationship is strictly linked to alcohol consumption. To evaluate: (1) the relationship between steatosis and either host or viral factors; (2) the correlation between steatosis and fibrosi s in patientswith CHC. A consecutive series of 349 patients were evaluated for teatosis. At liver biopsy, patients were tested for virological, and laboratory analysis and questioned for alcohol consumption. Logistic regression analysis de monstrated that steatosis was independently associated with genotype 3a (odds ra tio , OR 3.5), alcohol intake at the time of biopsy (OR 2.6) and age> 35 years (OR 2.7). In multivariate analysis the presence of fibrosis was associated with pa st alcohol abuse (OR 3.7), and age older than 44 years (OR 2.2). Overall, a weak correlation was found between grade of steatosis and fibrosis score (r = 0.861, P = 0.05), which disappeared excluding patients without past or current alcohol int ake. between grade of steatosis and both ’grading’ and ’staging’only in patients with genotypes other than 3a. Genotype 3a is t hemain risk factor for steatosis in patients with CHC. The grade of steatosis cor related with both grading and staging only in patients with genotypes other than 3a and this relationship is strictly linked to alcohol consumption.