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Impact of hepatic steatosis on viral kinetics and treatment outcome during antiviral treatment of chronic HCV infection

Journal article
Authors Johan Westin
Martin Lagging
Amar P Dhillon
Gunnar Norkrans
Ana Romero
Jean-Michel Pawlotsky
S. Zeuzem
Solko W Schalm
Elke Verheij-Hart
Francesco Negro
Gabriele Missale
Avidan U Neumann
Kristoffer Hellstrand
Published in J Viral Hepat
Volume 14
Issue 1
Pages 29-35
ISSN 1352-0504 (Print)
Publication year 2007
Published at Institute of Biomedicine, Department of Infectious Medicine
Pages 29-35
Language en
Keywords Adult, Antiviral Agents/ therapeutic use, Biopsy, Fatty Liver/ complications/virology, Female, Genotype, Hepacivirus/genetics/ growth & development, Hepatitis C, Chronic/ complications/ drug therapy/virology, Humans, Interferon Alfa-2a/ therapeutic use, Kaplan-Meiers Estimate, Kinetics, Male, Middle Aged, Polyethylene Glycols/ therapeutic use, RNA, Viral/blood, Ribavirin/ therapeutic use, Treatment Outcome
Subject categories Medical and Health Sciences


Liver steatosis is highly prevalent in chronic hepatitis C virus (HCV) infection, especially in patients infected with genotype 3 virus, but its significance for the outcome of antiviral treatment is not fully understood. We have monitored steatosis in liver biopsies from 231 patients with chronic HCV infection who received pegylated recombinant interferon-alpha and ribavirin in a phase III study (DITTO trial). The degree of steatosis, along with relevant metabolic parameters, was correlated with the early disappearance of virus and with the final outcome of treatment. Our data suggest that the presence of steatosis impairs the early reduction of viral load during treatment in patients infected with HCV genotype 3 and non-3. Steatosis negatively affected the final outcome of treatment mainly in patients infected with HCV genotype non-3 virus. Based on these findings, we propose that interventions aiming at reducing hepatic steatosis prior to the onset of antiviral therapy may be of benefit to patients infected with HCV of the non-3 genotypes. Patients infected with genotype 3, on the other hand, should be offered early antiviral treatment.

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