title: Hepatic steatosis in chronic hepatitis C patients infected with genotype 2 is associated with insulin resistance, hepatic fibrosis and affects cumulative positivity of serum hepatitis C virus RNA in peginterferon and ribavirin combination therapy.
abstract: OBJECTIVE
  Hepatic steatosis is one of the factors limiting the virological response to interferon-based antiviral therapy for chronic hepatitis C (CH-C) patients infected with genotype 1, while contradictory results have been reported for genotype 2. We aimed to clarify the effect of hepatic steatosis on therapeutic outcome and cumulative positivity of serum HCV RNA in CH-C patients infected with genotype 2 treated by peginterferon (PEG-IFN)α2b and ribavirin (RBV) combination therapy.
  
  
  METHODS
  A total of 74 treatment-naïve non-cirrhotic CH-C patients infected with genotype 2 who received PEG-IFNα2b and RBV according to the standard regimen were divided into hepatic steatosis 0-10% and >10% groups. The clinical backgrounds, sustained virological response (SVR) rates and cumulative positivity of serum HCV RNA were compared between the two groups.
  
  
  RESULTS
  Among the 74 patients, 61 (82.4%) had hepatic steatosis 0-10% and 13 (17.6%) had hepatic steatosis >10%. Scores of homeostasis model assessment-insulin resistance and hepatic fibrosis were higher in patients with hepatic steatosis >10% than hepatic steatosis 0-10% (P = 0.040 and 0.042, respectively). Non-SVR was more frequent in patients with hepatic steatosis >10% than hepatic steatosis 0-10% (P = 0.003). Cumulative positivity of serum HCV RNA was significantly higher in patients with hepatic steatosis >10% than hepatic steatosis 0-10% (P = 0.004).
  
  
  CONCLUSIONS
  In CH-C patients infected with genotype 2 treated by PEG-IFNα2b and RBV combination therapy, hepatic steatosis >10% was associated with increased insulin resistance, advanced hepatic fibrosis and higher cumulative positivity of serum HCV RNA, which lead to a higher risk of non-SVR.
authors.affiliation: Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto             Department of Gastroenterology, Matsushita Memorial Hospital             Hepatology Center, Saiseikai Suita Hospital, Osaka             Department of Gastroenterology and Hepatology Nara City Hospital, Nara, Japan.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Itoh
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nishimura
authors.forename: Kanji
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Chihiro
authors.initials: C
authors.lastname: Yokomizo
authors.forename: Hideki
authors.initials: H
authors.lastname: Fujii
authors.forename: Masahito
authors.initials: M
authors.lastname: Minami
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Nagao
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Sumida
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Hashimoto
authors.forename: Atsushi
authors.initials: A
authors.lastname: Umemura
authors.forename: Toshihide
authors.initials: T
authors.lastname: Shima
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okanoue
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Yoshikawa