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

Authors: Itoh, Yoshito¹; Nishimura, Takeshi¹; Yamaguchi, Kanji¹; Yokomizo, Chihiro¹; Fujii, Hideki¹; Minami, Masahito¹; Nagao, Yasuyuki²; Sumida, Yoshio³; Hashimoto, Hiroaki⁴; Umemura, Atsushi⁴; Shima, Toshihide⁴; Okanoue, Takeshi⁴; Yoshikawa, Toshikazu¹

Source: Hepatology Research, Volume 41, Number 12, 1 December 2011 , pp. 1145-1152(8)

Publisher: Wiley-Blackwell

Abstract:

Aim: 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.

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1872-034X.2011.00886.x

Affiliations:1: Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto2: Department of Gastroenterology, Matsushita Memorial Hospital3: Department of Gastroenterology and Hepatology Nara City Hospital, Nara, Japan4: Hepatology Center, Saiseikai Suita Hospital, Osaka

Publication date: 2011-12-01

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