Hepatitis C and hepatic steatosis

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QJM. 2010 Feb 4. [Epub ahead of print]

Hepatitis C and hepatic steatosis.

Patel JH, Cobbold JF, HC, - SD.

Liver Unit, Division of Diabetes Endocrinology and Metabolism, Department of

Medicine, Imperial College London, London W2 1NY, UK.

Hepatic steatosis is commonly seen in patients with chronic hepatitis C

infection, and the two together have a greater association than by chance alone.

Hepatitis C virus is closely associated with lipid metabolism throughout its

lifecycle. Hepatic steatosis is more common in genotype 3 infection, due to

direct viral effects including through microsomal triglyceride transfer protein,

peroxisome proliferator activating receptor, and sterol regulatory element

binding protein. In non-genotype 3 infection, hepatic steatosis is considered

largely to be due to alterations in host metabolism, particularly through

insulin resistance. The clinical relevance of this association has yet to be

fully explored. Hepatic steatosis is associated with increased hepatic fibrosis

and a reduced level of sustained virological response to pegylated interferon

and ribavirin. Small studies trialing adjuvant anti-diabetic therapies or

HMG-CoA reductase inhibitors with pegylated-interferon and ribavirin have shown

an improved sustained virological response and reduced viral titer. Furthermore,

simple lifestyle alterations showed positive effects on parameters of disease

activity. These insights raise the possibility of novel treatment options.

PMID: 20139103 [PubMed - as supplied by publisher]