, Volume 7, Issue 3, pp 127-133
Date: 16 Oct 2008

Impact of obesity, hepatic steatosis, and insulin resistance on hepatitis C treatment outcomes

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Hepatitis C virus (HCV) infection is commonly associated with hepatic steatosis, an important factor predicting disease severity in all genotypes. There appears to be a strong association between the presence of steatosis and insulin resistance (IR) in HCV infection, especially in genotype 1 infection. Obesity, hepatic steatosis, and IR all appear to negatively influence response to antiviral therapy. IR is important not only in the development of hepatic steatosis, but also in fibrosis severity. Recent studies also suggest that IR is a significant independent predictor of sustained virologic response to antiviral therapy, not only in genotype 1 infection but also in hepatitis C genotypes 2 and 3. It remains to be seen whether interventions such as weight loss, hepatic steatosis reduction, and improvement in IR will increase the response to antiviral therapy and/or delay disease progression in chronic hepatitis C.