Clinical Implications of Hepatic Steatosis in Patients with Chronic Hepatitis C: A Multicenter Study of U.S. Veterans |
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| Authors: | Ke-Qin Hu Sue L. Currie Hui Shen Ramsey C. Cheung Samuel B. Ho Edmund J. Bini John D. McCracken Tim Morgan Norbert Bräu Warren N. Schmidt Lennox Jeffers Teresa L. Wright |
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| Affiliation: | (1) Contributed to this study when he was the staff hepatologist at Loma Linda VA Medical Center, Loma Linda, California, USA;(2) Division of Gastroenterology/Hepatology, University of California, Irvine, 101 The City Drive, Building 53, Room 113, Orange, California 92868, USA;(3) Veteran Affairs Medical Center, San Francisco, California, USA;(4) Veteran Affairs Medical Center, Palo Alto, California, USA;(5) Veteran Affairs Medical Center, Minneapolis, Minnesota, USA;(6) Veteran Affairs Medical Center, New York, New York, USA;(7) Contributed to this study when he was the staff Gastroenterologist at Loma Linda VA Medical Center, Loma Linda, California, USA;(8) Kaiser Permanente 2025 Morse Avenue Sacramento, Sacramento, California, USA;(9) Veteran Affairs Medical Center, Long Beach, California, USA;(10) Veteran Affairs Medical Center, The Bronx, New York, USA;(11) Veteran Affairs Medical Center, Iowa City, Iowa, USA;(12) Veteran Affairs Medical Center, Miami, Florida, USA |
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| Abstract: | Studies have indicated a high prevalence of hepatic steatosis in patients with chronic hepatitis C (CHC). To address the impact of steatosis on the clinical course of CHC and treatment response requires large multicenter studies. The present study analyzed hepatitis C virus (HCV)-infected veterans enrolled in a U.S. Veteran Administration multicenter study of the epidemiology and response to interferon α-2b and ribavirin treatment. Of the 357 patients, 97.1% were males, with a mean age of 48.7±6.4 years, and 184 (51.5%) had hepatic steatosis. The mean body mass index (BMI) was 29.3±5.2 kg/m2, including 37.1% who were obese (BMI, ≥30 kg/m2). Stage III–IV fibrosis was present in 111 of 334 (33.3%) of the patients. After adjusting for age, race, and history of alcohol use in the past 12 months, only stage III–IV fibrosis was independently and significantly associated with hepatic steatosis (P=0.03). There was a trend of association between obesity and steatosis independent of the other factors. Only HCV genotype was independently associated with a sustained virological response (SVR) to interferon α-2b and ribavirin treatment after adjusting for age, alcohol use, steatosis, BMI, stage III–IV fibrosis, serum AFP, and HCV load. In conclusion, analyses of our multicenter trial data demonstrated that the prevalence of hepatic steatosis is 51.5% in HCV-infected U.S. veterans. We found that steatosis is independently associated with stage III–IV fibrosis. However, only HCV genotype, and not steatosis, obesity, or stage III–IV fibrosis, was associated with SVR to interferon α-2b and ribavirin treatment. Other members of the VA HCV-001 Study Group are listed in the Appendix |
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| Keywords: | Hepatitis C virus Chronic hepatitis C Hepatic steatosis Obesity Body mass index Hepatic fibrosis |
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