title: Hepatic steatosis in genotype 4 chronic hepatitis C patients: implication for therapy.
abstract: OBJECTIVE
  The association of hepatitis C virus genotype 4 (HCV-4) with hepatic steatosis has not been clarified. We aimed to determine the parameters associated with steatosis among HCV-4 patients and to assess the effect of steatosis on treatment with peginterferon and ribavirin.
  
  
  METHODS
  In a prospective study; 131 nondiabetic genotype 4 CHC patients were enrolled for analysis, treated with peginterferon-α-2b/ribavirin. Histopathologic, anthropometric, clinical, biochemical features, and insulin resistance (IR) estimated by the homeostasis model assessment index (HOMA-IR).
  
  
  RESULTS
  Hepatic steatosis was present in 58 patients (44.2%); 62% of them experienced mild steatosis. In univariable analysis, steatosis was associated with HOMA-IR, body mass index, waist circumference, serum triglycerides, cholesterol level, systolic hypertension, and histologic scores for inflammation and fibrosis. Multivariate analysis revealed that body mass index, waist circumference, and HOMA-IR were found to be significantly associated with steatosis. IR but not steatosis was associated with a lower rate of sustained virologic response when adjusted for known factors that predict response (odds ratio: 0.16, 95% CI 0.046-0.59, P=0.005).
  
  
  CONCLUSIONS
  In HCV-4 patients, the prevalence of steatosis was 44.2%; the majority (62%) has mild steatosis. Steatosis was significantly associated with metabolic factors. IR but not steatosis was independently associated with lower sustained virologic response.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Minya University Hospital, Egypt. mkhattabmed@hotmail.com
authors.forename: Mahmoud Aboelneen
authors.initials: MA
authors.lastname: Khattab
authors.forename: Mohammed Emad
authors.initials: ME
authors.lastname: Abdel-fattah
authors.forename: Mohammed
authors.initials: M
authors.lastname: Eslam
authors.forename: Asharf
authors.initials: A
authors.lastname: Abdelaleem
authors.forename: Rabab Atef
authors.initials: RA
authors.lastname: Abdelaleem
authors.forename: Mohammed
authors.initials: M
authors.lastname: Shatat
authors.forename: Ahmed
authors.initials: A
authors.lastname: Ali
authors.forename: Lamia
authors.initials: L
authors.lastname: Hamdy
authors.forename: Heba
authors.initials: H
authors.lastname: Tawfek
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D001794:Blood Pressure; D015992:Body Mass Index; D016009:Chi-Square Distribution; D002784:Cholesterol / Q000097:blood; D004359:Drug Therapy, Combination; D004534:Egypt; D005234:Fatty Liver / Q000097:blood / Q000503:physiopathology / Q000821:virology*; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007333:Insulin Resistance; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use*; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D019562:Viral Load; D055105:Waist Circumference
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D014280:Triglycerides; D011092:Polyethylene Glycols; D012254:Ribavirin; D002784:Cholesterol; C417083:peginterferon alfa-2b