title: Clinical implications of hepatic steatosis in patients with chronic hepatitis C: a multicenter study of U.S. veterans.
abstract: Studies have indicated a high prevalence of hepatic steatosis in patients with chronic hepatitis C (CHC). To address the impact of steatosis on the clinical course of CHC and treatment response requires large multicenter studies. The present study analyzed hepatitis C virus (HCV)-infected veterans enrolled in a U.S. Veteran Administration multicenter study of the epidemiology and response to interferon alpha-2b and ribavirin treatment. Of the 357 patients, 97.1% were males, with a mean age of 48.7+/-6.4 years, and 184 (51.5%) had hepatic steatosis. The mean body mass index (BMI) was 29.3+/-5.2 kg/m(2), including 37.1% who were obese (BMI, > or =30 kg/m(2)). Stage III-IV fibrosis was present in 111 of 334 (33.3%) of the patients. After adjusting for age, race, and history of alcohol use in the past 12 months, only stage III-IV fibrosis was independently and significantly associated with hepatic steatosis (P=0.03). There was a trend of association between obesity and steatosis independent of the other factors. Only HCV genotype was independently associated with a sustained virological response (SVR) to interferon alpha-2b and ribavirin treatment after adjusting for age, alcohol use, steatosis, BMI, stage III-IV fibrosis, serum AFP, and HCV load. In conclusion, analyses of our multicenter trial data demonstrated that the prevalence of hepatic steatosis is 51.5% in HCV-infected U.S. veterans. We found that steatosis is independently associated with stage III-IV fibrosis. However, only HCV genotype, and not steatosis, obesity, or stage III-IV fibrosis, was associated with SVR to interferon alpha-2b and ribavirin treatment.
authors.affiliation: Loma Linda VA Medical Center, Loma Linda, CA, USA. kqhu@uci.edu
authors.forename: Ke-Qin
authors.initials: KQ
authors.lastname: Hu
authors.forename: Sue L
authors.initials: SL
authors.lastname: Currie
authors.forename: Hui
authors.initials: H
authors.lastname: Shen
authors.forename: Ramsey C
authors.initials: RC
authors.lastname: Cheung
authors.forename: Samuel B
authors.initials: SB
authors.lastname: Ho
authors.forename: Edmund J
authors.initials: EJ
authors.lastname: Bini
authors.forename: John D
authors.initials: JD
authors.lastname: McCracken
authors.forename: Tim
authors.initials: T
authors.lastname: Morgan
authors.forename: Norbert
authors.initials: N
authors.lastname: Bräu
authors.forename: Warren N
authors.initials: WN
authors.lastname: Schmidt
authors.forename: Lennox
authors.initials: L
authors.lastname: Jeffers
authors.forename: Teresa L
authors.initials: TL
authors.lastname: Wright
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D015992:Body Mass Index; D005234:Fatty Liver / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000453:epidemiology* / Q000821:virology; D006787:Hospitals, Veterans / Q000706:statistics & numerical data*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D012254:Ribavirin