Skip to main content

Advertisement

SpringerLink
Log in

Prevalence and Impact of Hepatic Steatosis on the Response to Antiviral Therapy in Saudi Patients with Genotypes 1 and 4 Chronic Hepatitis C

  • Original Article
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Background

Hepatic steatosis in hepatitis C virus (HCV)-infected patients has been shown to enhance the progression of liver fibrosis and decrease the response to antiviral therapy.

Aims

We aimed to determine the role of HCV genotype 4 (HCV-G4) in the prevalence of hepatic steatosis, its impact on antiviral therapy, and its associations and predictive factors in comparison to HCV-G1-infected patients.

Methods

Treatment-naïve HCV patients who were started on pegylated interferon a-2b plus ribavirin therapy in two centers in Saudi Arabia were included. The severity of steatosis was assessed using the METAVIR and NAS (non-alcoholic fatty liver disease [NAFLD] activity score) scoring systems. Sustained virological response (SVR) was studied in relation to the degree of steatosis. Associations between steatosis and multiple demographic, laboratory, and virological factors were examined. HCV-G1 and HCV-G4 patients were compared.

Results

A total of 116 patients (HCV-G4 85 [73.3%]; HCV-G1 31 [26.7%]) were included. The mean age was 50.4 ± 10.7 years and 56.9% were males. In terms of steatosis grading using the NAS scoring system, 50% had steatosis grade 0, 26.7% grade 1, 14.7% grade 2, and 8.6% grade 3, while the overall staging of steatosis revealed that 43.1% had mild steatosis, 42.2% moderate, and 14.7% severe. Gamma-glutamyl transpeptidase (GGT), platelet count, body mass index (BMI), cholesterol level, presence of hyperlipidemia, liver histology stage, and grade were significantly correlated with hepatic steatosis in one or more of the statistical analyses. Twenty-two out of 55 patients (40.0%) had an SVR in the mild steatosis group, compared to 52.7% in the moderate group and 7.3% in the severe group (P = 0.03). The HCV genotype did not correlate with steatosis or SVR.

Conclusion

Our study confirms the high prevalence of steatosis in HCV-G4 and HCV-G1 patients, but with no difference in the grade or score of steatosis between the two genotypes. The grade of steatosis correlates with GGT, platelet count, and BMI, while the NAS score of steatosis correlates with response to antiviral therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Alter MJ. Epidemiology of hepatitis C virus infection. World J Gastroenterol. 2007;7:2436–2441.

    Google Scholar 

  2. Soresi M, Tripi S, Franco V, et al. Impact of liver steatosis on the antiviral response in the hepatitis C virus-associated chronic hepatitis. Liver Int. 2006;26:1119–1125.

    Article  PubMed  CAS  Google Scholar 

  3. Osoba AO. Hepatitis C virus genotypes in Saudi Arabia. Saudi Med J. 2002;23:7–12.

    PubMed  Google Scholar 

  4. Negro F. Mechanisms and significance of liver steatosis in hepatitis C virus infection. World J Gastroenterol. 2006;14:6756–6765.

    Google Scholar 

  5. Alaei M, Negro F. Hepatitis C virus and glucose and lipid metabolism. Diabetes Metab. 2008;34:692–700.

    Article  PubMed  CAS  Google Scholar 

  6. Bedossa P, Poynard T. An algorithm for the grading of activity in chronic hepatitis C. The METAVIR Cooperative Study Group. Hepatology. 1996;24:289–293.

    Article  PubMed  CAS  Google Scholar 

  7. Kleiner DE, Brunt EM, Van Natta M, et al. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology. 2005;41:1313–1321.

    Article  PubMed  Google Scholar 

  8. Khattab MA, Abdel-Fattah ME, Eslam M, et al. Hepatic steatosis in genotype 4 chronic hepatitis C patients: implication for therapy. J Clin Gastroenterol. 2010; (Epub ahead of print).

  9. Leandro G, Mangia A, Hui J, et al. Relationship between steatosis, inflammation, and fibrosis in chronic hepatitis C: a meta-analysis of individual patient data. Gastroenterology. 2006;130:1636–1642.

    Article  PubMed  Google Scholar 

  10. Tsochatzis E, Papatheodoridis GV, Manesis EK, et al. Hepatic steatosis in genotype 4 chronic hepatitis C is mainly because of metabolic factors. Am J Gastroenterol. 2007;102:634–641.

    Article  PubMed  Google Scholar 

  11. Reddy KR, Govindarajan S, Marcellin P, et al. Hepatic steatosis in chronic hepatitis C: baseline host and viral characteristics and influence on response to therapy with peginterferon alpha-2a plus ribavirin. J Viral Hepat. 2008;15(2):129–136.

    PubMed  CAS  Google Scholar 

  12. Khattab M, Eslam M, Sharwae MA, et al. Insulin resistance predicts rapid virologic response to peginterferon/ribavirin combination therapy in hepatitis C genotype 4 patients. Am J Gastroenterol. 2010; (Epub ahead of print).

  13. Esmat G, El Akel W, Metwally M, et al. Improvement of steatosis after interferon therapy in HCV genotype 4 is related to weight loss. Indian J Gastroenterol. 2009;28:45–48.

    Article  PubMed  CAS  Google Scholar 

  14. Patton HM, Patel K, Behling C, et al. The impact of steatosis on disease progression and early and sustained treatment response in chronic hepatitis C patients. J Hepatol. 2004;40:484–490.

    Article  PubMed  Google Scholar 

  15. Akuta N, Suzuki F, Tsubota A, et al. Efficacy of interferon monotherapy to 394 consecutive naïve cases infected with hepatitis C virus genotype 2a in Japan: therapy efficacy as consequence of tripartite interaction of viral, host and interferon treatment-related factors. J Hepatol. 2002;37:831–836.

    Article  PubMed  CAS  Google Scholar 

  16. Lo Iacono O, Venezia G, Petta S, et al. The impact of insulin resistance, serum adipocytokines and visceral obesity on steatosis and fibrosis in patients with chronic hepatitis C. Aliment Pharmacol Ther. 2007;25(10):1181–1191.

    Article  PubMed  CAS  Google Scholar 

  17. Bressler BL, Guindi M, Tomlinson G, et al. High body mass index is an independent risk factor for nonresponse to antiviral treatment in chronic hepatitis C. Hepatology. 2003;38:639–644.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The authors wish to acknowledge the efforts of Mabel Kwei, Esther Robles, Grace Angeles, Abeer Salota, Alhassan Khalafahllah Hassan, and Waleed Saud Al-Zwidan in retrieving the patient records and biopsy slides, collecting the data, and other logistical support.

Author information

Authors and Affiliations

  1. Department of Medicine, College of Medicine, King Saud University, P.O. Box 2925 (59), Riyadh, 11461, Saudi Arabia

    Abdallah M. AlQaraawi, Ahmad Hersi, Waleed Al-hamoudi, Khalid A. Alswat & Ayman A. Abdo

  2. Department of Hepatobiliary Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia

    Faisal M. Sanai

  3. Department of Pathology, Riyadh Military Hospital, Riyadh, Saudi Arabia

    Hussa Al-Husseini

  4. Hepatology Unit, Department of Medicine, Riyadh Military Hospital, Riyadh, Saudi Arabia

    Ali Albenmousa, Molfi M. Al-Otaibi & Mohammed Syed

  5. Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia

    Abdulmalik AlSheikh & Lubna Rizwan Ahmed

  6. Liver Disease Research Center, King Saud University, Riyadh, Saudi Arabia

    Safiyya M. Ali, Waleed Al-hamoudi, Khalid A. Alswat & Ayman A. Abdo

Authors
  1. Abdallah M. AlQaraawi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Faisal M. Sanai
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hussa Al-Husseini
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ali Albenmousa
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Abdulmalik AlSheikh
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lubna Rizwan Ahmed
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ahmad Hersi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Molfi M. Al-Otaibi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Mohammed Syed
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Safiyya M. Ali
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Waleed Al-hamoudi
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Khalid A. Alswat
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Ayman A. Abdo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ayman A. Abdo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

AlQaraawi, A.M., Sanai, F.M., Al-Husseini, H. et al. Prevalence and Impact of Hepatic Steatosis on the Response to Antiviral Therapy in Saudi Patients with Genotypes 1 and 4 Chronic Hepatitis C. Dig Dis Sci 56, 1222–1228 (2011). https://doi.org/10.1007/s10620-010-1417-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-010-1417-9

Keywords

Search

Navigation