Review article: hepatitis C virus-associated steatosis--pathogenic mechanisms and clinical implications.
Steatosis is a common feature of chronic hepatitis C, and may be caused directly by the virus, as in genotype 3 infection, or be associated with host metabolic factors. The interaction of hepatitis C virus core protein with the lipoprotein secretion pathways causes the characteristic alterations of lipid metabolism observed in hepatitis C virus-related steatosis. Several pathogenic mechanisms are likely involved into the pathogenesis of hepatitis C virus-related steatosis, including hyper-homocysteinaemia, hypoadiponectinaemia and insulin resistance. Steatosis is a major determinant of the liver damage progression in chronic hepatitis C (CHC), and negatively affects the response rate to the interferon (IFN)-based anti-viral treatment. Moreover, recent evidence suggests that steatosis may contribute to liver carcinogenesis. Chronic hepatitis C is a recognized risk factor for type 2 diabetes and it could be implicated into the pathogenesis of atherosclerosis. The role of hepatitis C virus (HCV)-related steatosis in these epidemiological associations remains to be determined.
Adinolfi
L E
LE
Internal Medicine and Hepatology, Second University of Naples, Naples, Italy. luigielio.adinolfi@unina2.it
Durante-Mangoni
E
E
Zampino
R
R
Ruggiero
G
G
D052242:Adiponectin / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D002908:Chronic Disease; D005234:Fatty Liver / Q000150:complications* / Q000503:physiopathology; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D006710:Homocysteine / Q000097:blood; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D007372:Interferons / Q000627:therapeutic use; D050356:Lipid Metabolism / Q000502:physiology; D008103:Liver Cirrhosis / Q000150:complications
D052242:Adiponectin; D000998:Antiviral Agents; D006710:Homocysteine; D007372:Interferons