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Clinical Implications of Hepatic Steatosis in Patients with Chronic Hepatitis C: A Multicenter Study of U.S. Veterans

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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.

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Acknowledgments

Part of this work was published as an abstract in Hepatology, Volume 38 (Supplement 1), 445A, 2003, and presented at the 54th AASLD annual meeting, November 2003, in Boston. This work was funded in part by a grant from Schering-Plough Corporation and the VA National HIV/Hepatitis C Program. We would also like to thank Roche Molecular Systems, Inc., for providing Amplicor HCV Monitor Test Kits for the study of HCV RNA testing.

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Authors and Affiliations

  1. Contributed to this study when he was the staff hepatologist at Loma Linda VA Medical Center, Loma Linda, California, USA

    Ke-Qin Hu

  2. Division of Gastroenterology/Hepatology, University of California, Irvine, 101 The City Drive, Building 53, Room 113, Orange, California, 92868, USA

    Ke-Qin Hu

  3. Veteran Affairs Medical Center, San Francisco, California, USA

    Sue L. Currie, Hui Shen & Teresa L. Wright

  4. Veteran Affairs Medical Center, Palo Alto, California, USA

    Ramsey C. Cheung

  5. Veteran Affairs Medical Center, Minneapolis, Minnesota, USA

    Samuel B. Ho

  6. Veteran Affairs Medical Center, New York, New York, USA

    Edmund J. Bini

  7. Contributed to this study when he was the staff Gastroenterologist at Loma Linda VA Medical Center, Loma Linda, California, USA

    John D. McCracken

  8. Kaiser Permanente 2025 Morse Avenue Sacramento, Sacramento, California, USA

    John D. McCracken

  9. Veteran Affairs Medical Center, Long Beach, California, USA

    Tim Morgan

  10. Veteran Affairs Medical Center, The Bronx, New York, USA

    Norbert Bräu

  11. Veteran Affairs Medical Center, Iowa City, Iowa, USA

    Warren N. Schmidt

  12. Veteran Affairs Medical Center, Miami, Florida, USA

    Lennox Jeffers

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  1. Ke-Qin Hu
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for the VA HCV-001 Study Grouptitle

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Correspondence to Ke-Qin Hu.

Additional information

Other members of the VA HCV-001 Study Group are listed in the Appendix

Appendix: Other members of the VA HCV-001 study group

Appendix: Other members of the VA HCV-001 study group

David Johnson, MD, Bay Pines, FL; Paul King, Columbia, MO; Bhupinder Anand, Houston, TX; Joseph Awad, Nashville, TN; Bradford Waters, Memphis, TN; Marcos Pedrosa, Boston, MA; Kyong-Mi Chang, Philadelphia, PA; Ayse Aytaman, Brooklyn, NY; Franz Simon, Denver, CO; Curt Hagedorn, Atlanta, GA; Richard Moseley, Ann Arbor, MI; Jawad Ahmad, Pittsburgh, PA; Charles Mendenhall, Cincinnati, OH; Doris Strader, Washington, DC; Anna W. Sasaki, Portland, OR; Stephen Rossi, San Francisco, CA.

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Hu, KQ., Currie, S.L., Shen, H. et al. Clinical Implications of Hepatic Steatosis in Patients with Chronic Hepatitis C: A Multicenter Study of U.S. Veterans. Dig Dis Sci 52, 570–578 (2007). https://doi.org/10.1007/s10620-006-9418-4

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  • DOI: https://doi.org/10.1007/s10620-006-9418-4

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