title: Insulin resistance and steatosis in HBV-HCV co-infected patients: Role of PNPLA3 polymorphisms and impact on liver fibrosis progression.
abstract: OBJECTIVE
  To evaluate steatosis, insulin resistance (IR) and patatin-like phospholipase domain-containing 3 (PNPLA3) and their relation to disease progression in hepatitis B and C viruses (HCV-HBV) co-infected patients.
  
  
  METHODS
  Three hundred and thirty patients with biopsy proven chronic hepatitis were enrolled: 66 had HBV-HCV, 66 HBV and 198 HCV infection. Prevalence of steatosis, IR and PNPLA3 polymorphisms and their relation to anthropometric, biochemical, virological and histological parameters were evaluated.
  
  
  RESULTS
  Prevalence of steatosis in group HBV-HCV was similar to that in HCV (47.0% vs 49.5%, respectively); group HBV showed the lowest steatosis (33.3%). Group HBV-HCV had a lesser degree of steatosis than HCV (P = 0.016), lower HCV RNA levels (P = 0.025) and lower prevalence and degree of IR (P = 0.01). PNPLA3 polymorphisms were associated with steatosis. Group HBV-HCV showed higher levels of liver fibrosis than group HCV (P = 0.001), but similar to that observed in HBV group. In HBV-HCV group, liver fibrosis was not associated with steatosis, IR or PNPLA3. HBV infection was the independent predictor of advanced liver fibrosis.
  
  
  CONCLUSIONS
  HBV-HCV co-infected patients have lower degree of hepatic steatosis, IR and HCV RNA than HCV mono-infected; co-infected patients showed a more rapid liver fibrosis progression that seems to be due to the double infection and/or HBV dominance.
authors.affiliation: Rosa Zampino, Adriana Boemio, Aldo Marrone, Luciano Restivo, Maria Chiara Fascione, Riccardo Nevola, Luigi Elio Adinolfi, Department of Medical, Surgical, Neurological, Metabolic, and GeriatricSciences, Second University of Naples, 80100 Naples, Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: Zampino
authors.affiliation: Rosa Zampino, Adriana Boemio, Aldo Marrone, Luciano Restivo, Maria Chiara Fascione, Riccardo Nevola, Luigi Elio Adinolfi, Department of Medical, Surgical, Neurological, Metabolic, and GeriatricSciences, Second University of Naples, 80100 Naples, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Coppola
authors.affiliation: Rosa Zampino, Adriana Boemio, Aldo Marrone, Luciano Restivo, Maria Chiara Fascione, Riccardo Nevola, Luigi Elio Adinolfi, Department of Medical, Surgical, Neurological, Metabolic, and GeriatricSciences, Second University of Naples, 80100 Naples, Italy.
authors.forename: Grazia
authors.initials: G
authors.lastname: Cirillo
authors.affiliation: Rosa Zampino, Adriana Boemio, Aldo Marrone, Luciano Restivo, Maria Chiara Fascione, Riccardo Nevola, Luigi Elio Adinolfi, Department of Medical, Surgical, Neurological, Metabolic, and GeriatricSciences, Second University of Naples, 80100 Naples, Italy.
authors.forename: Adriana
authors.initials: A
authors.lastname: Boemio
authors.affiliation: Rosa Zampino, Adriana Boemio, Aldo Marrone, Luciano Restivo, Maria Chiara Fascione, Riccardo Nevola, Luigi Elio Adinolfi, Department of Medical, Surgical, Neurological, Metabolic, and GeriatricSciences, Second University of Naples, 80100 Naples, Italy.
authors.forename: Carmine
authors.initials: C
authors.lastname: Minichini
authors.affiliation: Rosa Zampino, Adriana Boemio, Aldo Marrone, Luciano Restivo, Maria Chiara Fascione, Riccardo Nevola, Luigi Elio Adinolfi, Department of Medical, Surgical, Neurological, Metabolic, and GeriatricSciences, Second University of Naples, 80100 Naples, Italy.
authors.forename: Aldo
authors.initials: A
authors.lastname: Marrone
authors.affiliation: Rosa Zampino, Adriana Boemio, Aldo Marrone, Luciano Restivo, Maria Chiara Fascione, Riccardo Nevola, Luigi Elio Adinolfi, Department of Medical, Surgical, Neurological, Metabolic, and GeriatricSciences, Second University of Naples, 80100 Naples, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Stanzione
authors.affiliation: Rosa Zampino, Adriana Boemio, Aldo Marrone, Luciano Restivo, Maria Chiara Fascione, Riccardo Nevola, Luigi Elio Adinolfi, Department of Medical, Surgical, Neurological, Metabolic, and GeriatricSciences, Second University of Naples, 80100 Naples, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Starace
authors.affiliation: Rosa Zampino, Adriana Boemio, Aldo Marrone, Luciano Restivo, Maria Chiara Fascione, Riccardo Nevola, Luigi Elio Adinolfi, Department of Medical, Surgical, Neurological, Metabolic, and GeriatricSciences, Second University of Naples, 80100 Naples, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Durante-Mangoni
authors.affiliation: Rosa Zampino, Adriana Boemio, Aldo Marrone, Luciano Restivo, Maria Chiara Fascione, Riccardo Nevola, Luigi Elio Adinolfi, Department of Medical, Surgical, Neurological, Metabolic, and GeriatricSciences, Second University of Naples, 80100 Naples, Italy.
authors.forename: Evangelista
authors.initials: E
authors.lastname: Sagnelli
authors.affiliation: Rosa Zampino, Adriana Boemio, Aldo Marrone, Luciano Restivo, Maria Chiara Fascione, Riccardo Nevola, Luigi Elio Adinolfi, Department of Medical, Surgical, Neurological, Metabolic, and GeriatricSciences, Second University of Naples, 80100 Naples, Italy.
authors.forename: Luciano
authors.initials: L
authors.lastname: Restivo
authors.affiliation: Rosa Zampino, Adriana Boemio, Aldo Marrone, Luciano Restivo, Maria Chiara Fascione, Riccardo Nevola, Luigi Elio Adinolfi, Department of Medical, Surgical, Neurological, Metabolic, and GeriatricSciences, Second University of Naples, 80100 Naples, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Salzillo
authors.affiliation: Rosa Zampino, Adriana Boemio, Aldo Marrone, Luciano Restivo, Maria Chiara Fascione, Riccardo Nevola, Luigi Elio Adinolfi, Department of Medical, Surgical, Neurological, Metabolic, and GeriatricSciences, Second University of Naples, 80100 Naples, Italy.
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Fascione
authors.affiliation: Rosa Zampino, Adriana Boemio, Aldo Marrone, Luciano Restivo, Maria Chiara Fascione, Riccardo Nevola, Luigi Elio Adinolfi, Department of Medical, Surgical, Neurological, Metabolic, and GeriatricSciences, Second University of Naples, 80100 Naples, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Nevola
authors.affiliation: Rosa Zampino, Adriana Boemio, Aldo Marrone, Luciano Restivo, Maria Chiara Fascione, Riccardo Nevola, Luigi Elio Adinolfi, Department of Medical, Surgical, Neurological, Metabolic, and GeriatricSciences, Second University of Naples, 80100 Naples, Italy.
authors.forename: Emanuele Miraglia
authors.initials: EM
authors.lastname: Del Giudice
authors.affiliation: Rosa Zampino, Adriana Boemio, Aldo Marrone, Luciano Restivo, Maria Chiara Fascione, Riccardo Nevola, Luigi Elio Adinolfi, Department of Medical, Surgical, Neurological, Metabolic, and GeriatricSciences, Second University of Naples, 80100 Naples, Italy.
authors.forename: Luigi Elio
authors.initials: LE
authors.lastname: Adinolfi
keywords: Hepatitis B and C viruses co-infection; Insulin resistance; Liver fibrosis; Patatin-like phospholipase domain-containing 3; Steatosis