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Interferon-associated hepatic steatosis is related to discrepancies in biochemical and virological responses of chronic hepatitis C to IFN-based therapy

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Abstract

Background and aims

A discrepancy in virological and biochemical responses may occur throughout interferon-based therapy for hepatitis C virus (HCV). We aimed to explore the risk, associated factors, potential mechanisms, and impact on the treatment outcome of the discrepancy.

Subjects and methods

Consecutive 496, chronic HCV-infected patients receiving interferon/ribavirin or peginterferon/ribavirin for 24 weeks with a 24-week follow-up period were enrolled. Of 433 patients with pretreatment liver biopsy, 46 received serial liver biopsies at the end of treatment and end of follow-up to explore the corresponding change in liver histopathology. A virological/biochemical discrepancy was defined as persistently elevated alanine aminotransferase levels throughout the treatment period, despite the seronegativity for HCV RNA at least at the end of treatment. The sustained virological response (SVR) was defined as seronegativity for HCV RNA 6 months after the end of treatment.

Results

Virological/biochemical discrepancy was observed in 28.7 % (137/478) patients. The SVR rate was comparable between patients with (75.2 %, 103/137) and without discrepancy (81.2 %, 277/341, p = 0.14). For patients with discrepancy and SVR, 78 (75.7 %) had a subsequent normalization of alanine aminotransferase. Hepatic steatosis, advanced fibrosis, obesity, older age, peginterferon preparation, and low viral load were independently predictive of a virological/biochemical discrepancy. Serial liver histology showed that significant transient aggravation of hepatic steatosis during interferon-based therapy was observed among patients with a virological/biochemical discrepancy (difference 0.64 ± 0.93, p = 0.022), but not among those without it (difference 0.09 ± 0.69, p = 0.447).

Conclusions

A virological/biochemical discrepancy no longer exists after treatment cessation in most patients, and had little impact on the HCV treatment outcome. Treatment-related hepatic steatosis might play an important role in the pathogenesis of the discrepancy.

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Acknowledgements

Financial support was provided by Taiwan Liver Research Foundation.

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Authors and Affiliations

  1. Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Chun-Hao Chen, Jee-Fu Huang & Chung-Feng Huang

  2. Department of Internal Medicine, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan

    Chun-Hao Chen

  3. Faculty of Internal Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Jee-Fu Huang, Ming-Yen Hsieh, Zu-Yau Lin, Shinn-Cherng Chen, Ming-Yuh Hsieh, Liang-Yen Wang, Wan-Long Chuang, Chia-Yen Dai & Ming-Lung Yu

  4. Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan

    Jee-Fu Huang & Nai-Jen Hou

  5. Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan

    Chung-Feng Huang, Ming-Yen Hsieh & Ming-Lung Yu

  6. Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Rd, Kaohsiung, 807, Taiwan

    Chung-Feng Huang, Ming-Lun Yeh, Jeng-Fu Yang, Ming-Yen Hsieh, Zu-Yau Lin, Shinn-Cherng Chen, Ming-Yuh Hsieh, Liang-Yen Wang, Wan-Long Chuang, Chia-Yen Dai & Ming-Lung Yu

  7. Department of Preventive Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

    Jeng-Fu Yang

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  1. Chun-Hao Chen
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Correspondence to Ming-Lung Yu.

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Chen, CH., Huang, JF., Huang, CF. et al. Interferon-associated hepatic steatosis is related to discrepancies in biochemical and virological responses of chronic hepatitis C to IFN-based therapy. Hepatol Int 7, 162–170 (2013). https://doi.org/10.1007/s12072-012-9388-x

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  • DOI: https://doi.org/10.1007/s12072-012-9388-x

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