The impact of obesity and metabolic syndrome on chronic hepatitis C

Clin Liver Dis. 2014 Feb;18(1):147-56. doi: 10.1016/j.cld.2013.09.007. Epub 2013 Oct 24.


The metabolic syndrome and the hepatitis C virus (HCV) infection are 2 global health care challenges with a complex interaction. Insulin resistance, a central component of the metabolic syndrome, is epidemiologically and pathophysiologically intrinsically linked to HCV infection. Insulin resistance and diabetes affect clinical outcomes in patients with liver disease related to HCV, namely, incidence of hepatocellular carcinoma, liver-related mortality, fibrosis progression rate, response to antiviral therapy, and possibly the incidence of cardiovascular events. Viral and metabolic steatosis and its interactions with HCV and the metabolic syndrome are discussed. Management and the need for further research conclude the article.

Keywords: Diabetes; Fibrosis; Hypertension; Insulin resistance; Liver; Steatosis.

Publication types

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

MeSH terms

  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / metabolism
  • Disease Progression
  • Fatty Liver / etiology
  • Fatty Liver / metabolism
  • Female
  • Hepatitis C, Chronic / complications*
  • Hepatitis C, Chronic / metabolism
  • Humans
  • Insulin Resistance
  • Male
  • Metabolic Syndrome / complications*
  • Metabolic Syndrome / metabolism
  • Non-alcoholic Fatty Liver Disease
  • Obesity / complications*
  • Obesity / metabolism
  • Risk Factors