title: Impact of liver steatosis on virological response in [corrected] Italian patients with chronic hepatitis C treated with peg-interferon alpha-2b plus ribavarin.
abstract: BACKGROUND
  Whether liver steatosis affects sustained virological response in patients with chronic hepatitis C is still under discussion.
  
  
  OBJECTIVE
  To evaluate the impact of liver steatosis in patients treated (for chronic hepatitis C) with combination therapy.
  
  
  METHODS
  We evaluated 97 (male/female 82/15, mean age 41.1 years) consecutive naive patients treated with pegylated interferon alpha-2b plus ribavirin.
  
  
  RESULTS
  Prevalence and severity of liver steatosis were significantly associated with genotype 3a [grade 3-4 in 14 of 32 patients (44%) vs. 8 of 65 patients (12%) with other genotypes; P = 0.001], while steatosis grade 1 (<10% of hepatocytes affected) was more frequently associated with genotype 1a/1b [9/39 (23%) vs. 4/57 (7%); P = 0.02]. Overall, sustained virological response was 62.8%, and was statistically uninfluenced by the presence/absence of liver steatosis. On the contrary, the following variables were independently associated with sustained virological response at logistic regression analysis: genotype other than 1a/1b, positive association, (odds ratio 3.4, P < 0.04), and low-grade liver steatosis, negative association, (odds ratio 9.0, P = 0.009), whereas sustained virological response was unaffected by severe liver steatosis, which was mainly associated with genotypes 2 and 3 [steatosis grade 2, 18/29 (62%); grade 3, 10/12 (83%); grade 4, 7/10 (70%)].
  
  
  CONCLUSIONS
  Only low-grade liver steatosis negatively affects the outcome of combination therapy, with peginterferon alpha-2b plus ribavirin, while severe steatosis (which is virus-related in most cases) has no impact on virological response.
authors.affiliation: Department of Infectious Diseases and Tropical Medicine, S. Bortolo Hospital, Vicenza, Italy. pfabris@yahoo.com
authors.forename: P
authors.initials: P
authors.lastname: Fabris
authors.forename: A
authors.initials: A
authors.lastname: Floreani
authors.forename: A
authors.initials: A
authors.lastname: Carlotto
authors.forename: V
authors.initials: V
authors.lastname: Baldo
authors.forename: L
authors.initials: L
authors.lastname: Bozzola
authors.forename: M T
authors.initials: MT
authors.lastname: Giordani
authors.forename: F
authors.initials: F
authors.lastname: Negro
authors.forename: M
authors.initials: M
authors.lastname: Rassu
authors.forename: A
authors.initials: A
authors.lastname: Tramarin
authors.forename: F
authors.initials: F
authors.lastname: de Lalla
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D005234:Fatty Liver / Q000150:complications*; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D011092:Polyethylene Glycols; D011994:Recombinant Proteins; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b