Issue: Vojnosanit Pregl 2017; Vol. 74 (No. 4)

The influence of hepatic steatosis on the success of antiviral therapy for chronic hepatitis C

Authors:
Tomislav Preveden, Maja Ružić, Maria Pete

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Background/Aim. Chronic hepatitis C and liver steatosis often
appear simultaneously in the same person, and steatosis can
lead to worsening of liver disease and reducing the success of
the treatment of chronic hepatitis C. Treatment of one disease
can influence and cause favorable impact on treatment of other
diseases. The aim of this study was to determine the incidence
of liver steatosis in patients with chronic hepatitis C and to examine
the impact of steatosis of the liver and other predictors
on the success of antiviral therapy for chronic hepatitis C.
Methods. The study included 123 patients with chronic hepatitis
C treated with pegylated interferon alfa 2a in combination
with ribavirin. The patients were divided into two groups based
on the presence of cirrhosis: the group I consisted of 43
(34.9%) patients with steatosis and the group II consisted of 80
(65.1%) patients without liver steatosis. The success of the
treatment was evaluated on the basis of the stable virological
response. Results. The presence of steatosis was determined in
34.96% of the patients. The overall success of antiviral therapy
was found in 74.79% of the patients. The success of antiviral
therapy was present in 62.79% of the patients with hepatic steatosis,
and in 81.25% the patients without steatosis (p < 0.05).
The success of antiviral treatments was seen in 80.95% of the
patients with hepatic steatosis and the genotype of hepatitis C
virus 3. The predictors of antiviral therapy success for chronic
hepatitis C in our study were patient's age, duration of infection,
genotype 3, steatosis and severe fibrosis or cirrhosis.
Conclusion. Liver steatosis is often present in patients with
chronic hepatitis C. It has negative impact on the efficacy of
antiviral therapy in patients with infection with genotype non-3
hepatitis C virus. Therefore, hepatic steatosis in these patients
must be eliminated or treated prior to application of antiviral
therapy.