Clinical Implications of Hepatic Steatosis in Patients with Chronic Hepatitis C: A Multicenter Study of U.S. Veterans

• DOI: 10.1007/s10620-006-9418-4
• Publication Date: 2007-01-16T23:32:25Z
• Authors: Ke-Qin Hu; Sue L. Currie; Hui Shen; Ramsey C. Cheung; Samuel B. Ho; Edmund J. Bini; John D. McCracken; Tim Morgan; Norbert Bräu; Warren N. Schmidt; Lennox Jeffers; Teresa L. Wright
• Keywords: Adult; Liver Cirrhosis; Male; Genotype; Hospitals, Veterans; Hepacivirus; Interferon alpha-2; Antiviral Agents; Body Mass Index; 03 medical and health sciences; 0302 clinical medicine; Prevalence; Humans; Obesity; Prospective Studies; Aged; 2. Zero hunger; Interferon-alpha; Hepatitis C, Chronic; Middle Aged; Recombinant Proteins; 3. Good health; Fatty Liver; Female

Studies have indicated a high prevalence of hepatic steatosis in patients with chronic hepatitis C (CHC). To address the impact of steatosis on the clinical course of CHC and treatment response requires large multicenter studies. The present study analyzed hepatitis C virus (HCV)-infected veterans enrolled in a U.S. Veteran Administration multicenter study of the epidemiology and response to interferon alpha-2b and ribavirin treatment. Of the 357 patients, 97.1% were males, with a mean age of 48.7+/-6.4 years, and 184 (51.5%) had hepatic steatosis. The mean body mass index (BMI) was 29.3+/-5.2 kg/m(2), including 37.1% who were obese (BMI, > or =30 kg/m(2)). Stage III-IV fibrosis was present in 111 of 334 (33.3%) of the patients. After adjusting for age, race, and history of alcohol use in the past 12 months, only stage III-IV fibrosis was independently and significantly associated with hepatic steatosis (P=0.03). There was a trend of association between obesity and steatosis independent of the other factors. Only HCV genotype was independently associated with a sustained virological response (SVR) to interferon alpha-2b and ribavirin treatment after adjusting for age, alcohol use, steatosis, BMI, stage III-IV fibrosis, serum AFP, and HCV load. In conclusion, analyses of our multicenter trial data demonstrated that the prevalence of hepatic steatosis is 51.5% in HCV-infected U.S. veterans. We found that steatosis is independently associated with stage III-IV fibrosis. However, only HCV genotype, and not steatosis, obesity, or stage III-IV fibrosis, was associated with SVR to interferon alpha-2b and ribavirin treatment.