The impact of steatosis on disease progression and early and sustained treatment response in chronic hepatitis C patients.
OBJECTIVE
Questions remain regarding the etiology of steatosis in hepatitis C, and its impact on disease progression and treatment outcomes.


METHODS
We evaluated liver biopsies from 574 patients with chronic hepatitis C from a single center.


RESULTS
Severity of steatosis was associated with body mass index, HCV genotype 3 infection, age, and duration of infection (P</=0.01). Serum HCV RNA levels were associated with severity of steatosis in HCV genotype 3 infection (P</=0.03). In HCV genotype 1 infection, fibrosis was associated with severity of steatosis (P<0.01), and patients who achieved SVR had lesser degrees of pre-treatment steatosis compared to nonresponders (4.6+/-1.6 vs. 10.1+/-1.1%, P=0.02). Genotype 1 infected patients with an early virologic response were more likely to have grade 0 steatosis compared to those without an early response (71 vs. 42%; P=0.003). Evaluation of paired biopsies demonstrated a marked decline in steatosis in genotype 3 patients who achieved SVR (P<0.01).


CONCLUSIONS
In conclusion, steatosis is an important cofactor in hepatitis C as it is associated with fibrosis and reduces the likelihood of achieving early and sustained virologic response in genotype 1 infected patients.
Patton
Heather M
HM
Division of Gastroenterology and Hepatology, Scripps Clinic, La Jolla, CA, USA.
Patel
Keyur
K
Behling
Cynthia
C
Bylund
David
D
Blatt
Lawrence M
LM
Vallée
Marc
M
Heaton
Shanon
S
Conrad
Andrew
A
Pockros
Paul J
PJ
McHutchison
John G
JG
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D001706:Biopsy; D015992:Body Mass Index; D015331:Cohort Studies; D018450:Disease Progression; D005234:Fatty Liver / Q000473:pathology / Q000821:virology*; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000187:drug effects / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy / Q000473:pathology* / Q000821:virology; D006801:Humans; D008099:Liver / Q000473:pathology / Q000821:virology; D008103:Liver Cirrhosis / Q000821:virology; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000998:Antiviral Agents