Hepatic Steatosis in Hepatitis C: Comparison of Diabetic and Nondiabetic Patients in the Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis Trial

Anna S F Lok, James E. Everhart, Raymond T. Chung, Latha Padmanabhan, Joel K. Greenson, Mitchell L. Shiffman, Gregory T. Everson, Karen L. Lindsay, Herbert L. Bonkovsky, Adrian M. Di Bisceglie, William M. Lee, Timothy R. Morgan, Marc G. Ghany, Chihiro Morishima

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Abstract

Background & Aims: Hepatic steatosis often is observed in patients with chronic hepatitis C and has been reported to be associated with hepatic fibrosis and impaired treatment response in some studies. Our aim was to determine the prevalence of and risk factors for hepatic steatosis among Hepatitis C Antiviral Long-term Treatment against Cirrhosis patients, and to determine the relationship between steatosis, fibrosis, and sustained virologic response (SVR) to re-treatment with pegylated interferon and ribavirin. Methods: Baseline data from 1143 Hepatitis C Antiviral Long-term Treatment against Cirrhosis patients, with a mean body mass index of 30, 5% with genotype 3, 38% with cirrhosis, and 24% with diabetes were analyzed. Results: Steatosis scores of 0, 1, 2, 3, and 4 were observed in 19%, 42%, 30%, 8%, and 1% of patients, respectively. High body mass index, triglyceride and alanine aminotransferase levels, and genotype 3 were associated with higher grades of steatosis. Among nondiabetic patients, steatosis scores of 0-2 but not scores of 3-4 were associated significantly with cirrhosis. For diabetic patients, there was no association between steatosis and cirrhosis. Similarly, steatosis scores of 2-4 were associated with a lack of SVR among nondiabetic but not among diabetic patients. Conclusions: In this cohort with predominantly hepatitis C virus genotype 1 infection, steatosis was associated strongly with metabolic factors that contribute to nonalcoholic fatty liver disease. Steatosis correlated with increasing stages of fibrosis up to but not including cirrhosis. Steatosis had a negative impact on SVR among nondiabetic but not diabetic patients. The discordant findings between nondiabetic and diabetic patients indicate that these 2 groups should be considered separately when analyzing metabolic factors and liver disease outcomes.

Original languageEnglish (US)
Pages (from-to)245-254
Number of pages10
JournalClinical Gastroenterology and Hepatology
Volume5
Issue number2
DOIs
StatePublished - Feb 2007

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Hepatitis C
Antiviral Agents
Fibrosis
Liver
Therapeutics
Genotype
Body Mass Index
Ribavirin
Metabolic Diseases
Chronic Hepatitis C
Alanine Transaminase
Hepacivirus
Interferons
Liver Diseases
Triglycerides
Infection

ASJC Scopus subject areas

  • Gastroenterology

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Hepatic Steatosis in Hepatitis C : Comparison of Diabetic and Nondiabetic Patients in the Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis Trial. / Lok, Anna S F; Everhart, James E.; Chung, Raymond T.; Padmanabhan, Latha; Greenson, Joel K.; Shiffman, Mitchell L.; Everson, Gregory T.; Lindsay, Karen L.; Bonkovsky, Herbert L.; Di Bisceglie, Adrian M.; Lee, William M.; Morgan, Timothy R.; Ghany, Marc G.; Morishima, Chihiro.

In: Clinical Gastroenterology and Hepatology, Vol. 5, No. 2, 02.2007, p. 245-254.

Research output: Contribution to journalArticle

Lok, ASF, Everhart, JE, Chung, RT, Padmanabhan, L, Greenson, JK, Shiffman, ML, Everson, GT, Lindsay, KL, Bonkovsky, HL, Di Bisceglie, AM, Lee, WM, Morgan, TR, Ghany, MG & Morishima, C 2007, 'Hepatic Steatosis in Hepatitis C: Comparison of Diabetic and Nondiabetic Patients in the Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis Trial', Clinical Gastroenterology and Hepatology, vol. 5, no. 2, pp. 245-254. https://doi.org/10.1016/j.cgh.2006.11.002
Lok, Anna S F ; Everhart, James E. ; Chung, Raymond T. ; Padmanabhan, Latha ; Greenson, Joel K. ; Shiffman, Mitchell L. ; Everson, Gregory T. ; Lindsay, Karen L. ; Bonkovsky, Herbert L. ; Di Bisceglie, Adrian M. ; Lee, William M. ; Morgan, Timothy R. ; Ghany, Marc G. ; Morishima, Chihiro. / Hepatic Steatosis in Hepatitis C : Comparison of Diabetic and Nondiabetic Patients in the Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis Trial. In: Clinical Gastroenterology and Hepatology. 2007 ; Vol. 5, No. 2. pp. 245-254.
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abstract = "Background & Aims: Hepatic steatosis often is observed in patients with chronic hepatitis C and has been reported to be associated with hepatic fibrosis and impaired treatment response in some studies. Our aim was to determine the prevalence of and risk factors for hepatic steatosis among Hepatitis C Antiviral Long-term Treatment against Cirrhosis patients, and to determine the relationship between steatosis, fibrosis, and sustained virologic response (SVR) to re-treatment with pegylated interferon and ribavirin. Methods: Baseline data from 1143 Hepatitis C Antiviral Long-term Treatment against Cirrhosis patients, with a mean body mass index of 30, 5{\%} with genotype 3, 38{\%} with cirrhosis, and 24{\%} with diabetes were analyzed. Results: Steatosis scores of 0, 1, 2, 3, and 4 were observed in 19{\%}, 42{\%}, 30{\%}, 8{\%}, and 1{\%} of patients, respectively. High body mass index, triglyceride and alanine aminotransferase levels, and genotype 3 were associated with higher grades of steatosis. Among nondiabetic patients, steatosis scores of 0-2 but not scores of 3-4 were associated significantly with cirrhosis. For diabetic patients, there was no association between steatosis and cirrhosis. Similarly, steatosis scores of 2-4 were associated with a lack of SVR among nondiabetic but not among diabetic patients. Conclusions: In this cohort with predominantly hepatitis C virus genotype 1 infection, steatosis was associated strongly with metabolic factors that contribute to nonalcoholic fatty liver disease. Steatosis correlated with increasing stages of fibrosis up to but not including cirrhosis. Steatosis had a negative impact on SVR among nondiabetic but not diabetic patients. The discordant findings between nondiabetic and diabetic patients indicate that these 2 groups should be considered separately when analyzing metabolic factors and liver disease outcomes.",
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T2 - Comparison of Diabetic and Nondiabetic Patients in the Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis Trial

AU - Lok, Anna S F

AU - Everhart, James E.

AU - Chung, Raymond T.

AU - Padmanabhan, Latha

AU - Greenson, Joel K.

AU - Shiffman, Mitchell L.

AU - Everson, Gregory T.

AU - Lindsay, Karen L.

AU - Bonkovsky, Herbert L.

AU - Di Bisceglie, Adrian M.

AU - Lee, William M.

AU - Morgan, Timothy R.

AU - Ghany, Marc G.

AU - Morishima, Chihiro

PY - 2007/2

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N2 - Background & Aims: Hepatic steatosis often is observed in patients with chronic hepatitis C and has been reported to be associated with hepatic fibrosis and impaired treatment response in some studies. Our aim was to determine the prevalence of and risk factors for hepatic steatosis among Hepatitis C Antiviral Long-term Treatment against Cirrhosis patients, and to determine the relationship between steatosis, fibrosis, and sustained virologic response (SVR) to re-treatment with pegylated interferon and ribavirin. Methods: Baseline data from 1143 Hepatitis C Antiviral Long-term Treatment against Cirrhosis patients, with a mean body mass index of 30, 5% with genotype 3, 38% with cirrhosis, and 24% with diabetes were analyzed. Results: Steatosis scores of 0, 1, 2, 3, and 4 were observed in 19%, 42%, 30%, 8%, and 1% of patients, respectively. High body mass index, triglyceride and alanine aminotransferase levels, and genotype 3 were associated with higher grades of steatosis. Among nondiabetic patients, steatosis scores of 0-2 but not scores of 3-4 were associated significantly with cirrhosis. For diabetic patients, there was no association between steatosis and cirrhosis. Similarly, steatosis scores of 2-4 were associated with a lack of SVR among nondiabetic but not among diabetic patients. Conclusions: In this cohort with predominantly hepatitis C virus genotype 1 infection, steatosis was associated strongly with metabolic factors that contribute to nonalcoholic fatty liver disease. Steatosis correlated with increasing stages of fibrosis up to but not including cirrhosis. Steatosis had a negative impact on SVR among nondiabetic but not diabetic patients. The discordant findings between nondiabetic and diabetic patients indicate that these 2 groups should be considered separately when analyzing metabolic factors and liver disease outcomes.

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