THE INFLUENCE OF STEATOSIS AND CONJUGATE FACTORS OF RESPONSE TO ANTIVIRAL TREATMENT IN CRONIC HEPATITIS C
THE INFLUENCE OF STEATOSIS AND CONJUGATE FACTORS OF RESPONSE TO ANTIVIRAL TREATMENT IN CRONIC HEPATITIS C

Summary/Abstract: HEPATITIS C VIRUS (HCV) IS A MAJOR CAUSE OF CHRONIC LIVER DISEASE WORLDWIDE. AN INCREASED PREVALENCE OF STEATOSIS IN PATIENTS WITH HCV IS WELL ESTABLISHED. MOSTSTUDIES HAVE REPORTED APPROXIMATELY 50% PREVALENCE OF STEATOSIS AMONG PATIENTSUNDERGOING A LIVER BIOPSY BECAUSE OF HCV. IN COMPARISON, AMONG PATIENTS WITH AUTOIMMUNE HEPATITIS AND HEPATITIS B (HBV), STEATOSIS IS NOT COMMONLY OBSERVED. HEPATITIS C VIRUS (HCV) INFECTION IS AN IMPORTANT RISK FACTOR FOR INSULIN RESISTANCE(IR). THE LATTER IS THE PATHOGENIC FOUNDATION UNDERLYING METABOLIC SYNDROME,STEATOSIS AND CIRRHOSIS, AND POSSIBLY HEPATOCELLULAR CARCINOMA (HCC). WHEREAS THEOVERALL PREVALENCE OF IR IS 10%-25% OF THE POPULATION, THE PREVALENCE IR IN HCVINFECTION REACHES FIGURES RANGING BETWEEN 30% TO 70%. OBESITY AND/OR STEATOSIS INPATIENTS WITH CHRONIC HCV HAS CONSISTENTLY BEEN SHOWN TO BE ASSOCIATED WITH ANIMPAIRED RESPONSE TO ANTIVIRAL TREATMENT WITH INTERFERON THERAPY. IT IS NOT CLEARWHETHER THIS ASSOCIATION BETWEEN OVERWEIGHT OR OBESITY AND POOR RESPONSE TOANTIVIRAL THERAPY IS DUE TO STEATOSIS AND MIGHT NOT ONLY BE LINKED TO OBESITY.ACCUMULATING EVIDENCE SUGGESTS THAT STEATOSIS PLAYS A ROLE IN HCV-RELATEDFIBROSIS, AND SUPPORT FOR THIS ALSO COMES FROM STUDIES SHOWING THAT WEIGHTREDUCTION IN THESE PATIENTS LEADS NOT ONLY TO A DECREASE IN STEATOSIS BUT ALSOIMPROVEMENT IN FIBROSIS SCORE.

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