Impact of obesity on treatment of chronic hepatitis C.
Obesity and the metabolic syndrome have hepatic manifestations, including steatosis and progression of fibrosis. In individuals with chronic hepatitis C, obesity is associated with inflammation, insulin resistance, steatosis, progression of fibrosis, and nonresponse to treatment with interferon or peginterferon alpha and ribavirin. Patients with both hepatitis C and obesity-related nonalcoholic fatty liver disease are at greater risk for more advanced liver disease. We review the mechanisms by which obesity may be associated with decreased efficacy of interferon-based therapies in individuals with chronic hepatitis C and the therapeutic strategies that may increase the effectiveness of these therapies in obese individuals.
Charlton
Michael R
MR
Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA. charlton.michael@mayo.edu
Pockros
Paul J
PJ
Harrison
Stephen A
SA
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D015992:Body Mass Index; D003131:Combined Modality Therapy; D015897:Comorbidity; D018450:Disease Progression; D005234:Fatty Liver / Q000453:epidemiology / Q000473:pathology; D005260:Female; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007333:Insulin Resistance; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000473:pathology; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology*; D011379:Prognosis; D011994:Recombinant Proteins; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins