Hepatitis C and lipid metabolism, hepatic steatosis, and NAFLD: still important in the era of direct acting antiviral therapy?

J Viral Hepat. 2014 Jan;21(1):1-8. doi: 10.1111/jvh.12172. Epub 2013 Oct 6.


Chronic hepatitis C (CHC) and nonalcoholic fatty liver disease (NAFLD) have an individual prevalence of 1.8-3% and at least 30%, respectively, in the United States. It is therefore not surprising that there is overlap between these two common chronic liver diseases, although the relationship appears to go beyond isolated co-existence. Hepatic steatosis is a common feature of CHC infection and can be related to both metabolic and viral specific factors. Steatosis in the setting of nongenotype 3 CHC has been predictive of response to therapy prior to the advent of the direct acting antiviral medications (DAAs). Similarly, lipid metabolism appears important in response to CHC treatment. The pathways for both lipid homeostasis and NAFLD as it pertains to CHC infection as well as the utilization of statin therapy in CHC infection will be reviewed with a focus on the relevance of these topics in the era of DAA therapy.

Keywords: NAFLD; cholesterol; hepatitis C; lipid metabolism; statins.

Publication types

  • Review

MeSH terms

  • Anticholesteremic Agents / therapeutic use
  • Antiviral Agents / therapeutic use*
  • Fatty Liver / epidemiology*
  • Fatty Liver / etiology*
  • Fatty Liver / pathology
  • Hepatitis C / complications*
  • Hepatitis C / epidemiology*
  • Hepatitis C / pathology
  • Lipid Metabolism*
  • Non-alcoholic Fatty Liver Disease
  • Prevalence
  • United States / epidemiology


  • Anticholesteremic Agents
  • Antiviral Agents