The impact of steatosis on disease progression and early and sustained treatment response in chronic hepatitis C patients

J Hepatol. 2004 Mar;40(3):484-90. doi: 10.1016/j.jhep.2003.11.004.


Background/aims: Questions remain regarding the etiology of steatosis in hepatitis C, and its impact on disease progression and treatment outcomes.

Methods: We evaluated liver biopsies from 574 patients with chronic hepatitis C from a single center.

Results: Severity of steatosis was associated with body mass index, HCV genotype 3 infection, age, and duration of infection (P</=0.01). Serum HCV RNA levels were associated with severity of steatosis in HCV genotype 3 infection (P</=0.03). In HCV genotype 1 infection, fibrosis was associated with severity of steatosis (P<0.01), and patients who achieved SVR had lesser degrees of pre-treatment steatosis compared to nonresponders (4.6+/-1.6 vs. 10.1+/-1.1%, P=0.02). Genotype 1 infected patients with an early virologic response were more likely to have grade 0 steatosis compared to those without an early response (71 vs. 42%; P=0.003). Evaluation of paired biopsies demonstrated a marked decline in steatosis in genotype 3 patients who achieved SVR (P<0.01).

Conclusions: In conclusion, steatosis is an important cofactor in hepatitis C as it is associated with fibrosis and reduces the likelihood of achieving early and sustained virologic response in genotype 1 infected patients.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Antiviral Agents / therapeutic use*
  • Biopsy
  • Body Mass Index
  • Cohort Studies
  • Disease Progression
  • Fatty Liver / pathology
  • Fatty Liver / virology*
  • Female
  • Genotype
  • Hepacivirus / drug effects
  • Hepacivirus / genetics
  • Hepatitis C, Chronic / complications*
  • Hepatitis C, Chronic / drug therapy
  • Hepatitis C, Chronic / pathology*
  • Hepatitis C, Chronic / virology
  • Humans
  • Liver / pathology
  • Liver / virology
  • Liver Cirrhosis / virology
  • Male
  • Middle Aged
  • Severity of Illness Index
  • Treatment Outcome


  • Antiviral Agents