What are the comorbidities influencing the management of patients and the response to therapy in chronic hepatitis C?
The natural history of chronic hepatitis C has been defined in several retrospective and prospective studies conducted in the last 20 years. These studies have clearly demonstrated that the outcome of chronic hepatitis C virus infection is profoundly influenced by a variety of cofactors and comorbidities. Many of the cofactors that affect the course of liver disease in hepatitis C also have a significant influence on the result of antiviral therapy. Unfortunately, comorbidities that have been shown to negatively influence the course and outcome of liver disease often reduce the chance of achieving a sustained virological response with pegylated interferon (PEG-IFN) and ribavirin treatment. The most important and frequent comorbidity influencing the course of chronic hepatitis C and the response to antiviral therapy is represented by the metabolic syndrome, and by the associated state of insulin resistance. Other comorbidities that have a negative influence on the progression of hepatitis C and on the response to antiviral therapy include excess alcohol intake, human immunodeficiency virus and hepatitis B virus co-infection and a number of conditions that reduce the benefit of therapy by affecting negatively compliance and/or adherence to adequate PEG-IFN or ribavirin doses.
Alberti
Alfredo
A
Department of Histology, Microbiology and Medical Biotechnologies, University of Padova, Padova, Italy. alfredo.alberti@unipd.it
D000437:Alcoholism / Q000503:physiopathology; D000998:Antiviral Agents / Q000627:therapeutic use*; D015897:Comorbidity; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000503:physiopathology; D006509:Hepatitis B / Q000503:physiopathology; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000503:physiopathology*; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D024821:Metabolic Syndrome / Q000503:physiopathology; D011092:Polyethylene Glycols; D011994:Recombinant Proteins; D012254:Ribavirin
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a