Skip to main content
SpringerLink
Log in

Steatosis in hepatitis C: What does it mean?

  • Published:
Current Hepatitis Reports Aims and scope Submit manuscript

Abstract

Hepatitis C and nonalcoholic fatty liver disease (NAFLD) are both common causes of liver disease. Thus, it is not surprising that they can coexist in the same individual. The prevalence of steatosis in patients with chronic hepatitis C differs between studies, probably reflecting population differences in known risk factors for steatosis, namely overweight, diabetes, and dyslipidemia. The pathogenic significance of steatosis likely differs according to its origin, metabolic (NAFLD or nonalcoholic steatohepatitis) or virus related (due to hepatitis C virus genotype 3). Whether or not steatosis determines fibrosis progression is not yet unproven.

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 and Recommended Reading

  1. Sanyal AJ: AGA technical review on nonalcoholic fatty liver disease. Gastroenterology 2002, 123:1705–1725.

    Article  PubMed  Google Scholar 

  2. Clark JM, Brancati FL, Diehl AM: Nonalcoholic fatty liver disease. Gastroenterology 2002, 122:1649–1657.

    Article  PubMed  Google Scholar 

  3. Neuschwander Tetri BA, Caldwell SH: Nonalcoholic steatohepatitis: summary of an AASLD Single Topic Conference. Hepatology 2003, 37:1202–1219.

    Article  PubMed  Google Scholar 

  4. Chitturi S, Farrell GC: Etiopathogenesis of nonalcoholic steatohepatitis. Semin Liver Dis 2001, 21:27–41.

    Article  PubMed  CAS  Google Scholar 

  5. Brunt EM, Tiniakos DG: Steatosis, steatohepatitis: review of effects on chronic hepatitis C. Curr Hepat Rep 2002, 1:38–44. Provides insights into steatosis, steatohepatitis, and chronic hepatitis C.

    Google Scholar 

  6. Wanless IR, Lentz JS: Fatty liver hepatitis (steatohepatitis) and obesity: an autopsy study with analysis of risk factors. Hepatology 1990, 12:1106–1110.

    Article  PubMed  CAS  Google Scholar 

  7. Skelly MM, James PD, Ryder SD: Findings on liver biopsy to investigate abnormal liver function tests in the absence of diagnostic serology. J Hepatol 2001, 35:195–199.

    Article  PubMed  CAS  Google Scholar 

  8. Barba G, Harper F, Harada T, et al.: Hepatitis C virus core protein shows a cytoplasmic localization and associates to cellular lipid storage droplets. Proc Natl Acad Sci U S A 1997, 94:1200–1205.

    Article  PubMed  CAS  Google Scholar 

  9. Shi ST, Polyak SJ, Tu H, et al.: Hepatitis C virus NS5A colocalizes with the core protein on lipid droplets and interacts with apolipoproteins. Virology 2002, 292:198–210.

    Article  PubMed  CAS  Google Scholar 

  10. Perlemuter G, Sabile A, Letteron P, et al.: Hepatitis C virus core protein inhibits microsomal triglyceride transfer protein activity and very low density lipoprotein secretion: a model of viral-related steatosis. FASEB J 2002, 16:185–194.

    Article  PubMed  CAS  Google Scholar 

  11. Lerat H, Honda M, Beard MR, et al.: Steatosis and liver cancer in transgenic mice expressing the structural and nonstructural proteins of hepatitis C virus. Gastroenterology 2002, 122:352–365.

    Article  PubMed  CAS  Google Scholar 

  12. Okuda M, Li K, Beard MR, et al.: Mitochondrial injury, oxidative stress, and antioxidant gene expression are induced by hepatitis C virus core protein. Gastroenterology 2002, 122:366–375.

    Article  PubMed  CAS  Google Scholar 

  13. Mihm S, Fayyazi A, Hartmann H, Ramadori G: Analysis of histopathological manifestations of chronic hepatitis C virus infection with respect to virus genotype. Hepatology 1997, 25:735–739.

    Article  PubMed  CAS  Google Scholar 

  14. Czaja AJ, Carpenter HA, Santrach PJ, Moore SB: Host- and disease-specific factors affecting steatosis in chronic hepatitis C. J Hepatol 1998, 29:198–206.

    Article  PubMed  CAS  Google Scholar 

  15. Hourigan LF, Macdonald GA, Purdie D, et al.: Fibrosis in chronic hepatitis C correlates significantly with body mass index and steatosis. Hepatology 1999, 29:1215–1219.

    Article  PubMed  CAS  Google Scholar 

  16. Rubbia-Brandt L, Quadri R, Abid K, et al.: Hepatocyte steatosis is a cytopathic effect of hepatitis C virus genotype 3. J Hepatol 2000, 33:106–115.

    Article  PubMed  CAS  Google Scholar 

  17. Adinolfi LE, Gambardella M, Andreana A, et al.: Steatosis accelerates the progression of liver damage of chronic hepatitis C patients and correlates with specific HCV genotype and visceral obesity. Hepatology 2001, 33:1358–1364.

    Article  PubMed  CAS  Google Scholar 

  18. Serfaty L, Andreani T, Giral P, et al.: Virus induced hypobetalipoproteinemia: a possible mechanism for steatosis in chronic hepatitis C. J Hepatol 2001, 34:428–434.

    Article  PubMed  CAS  Google Scholar 

  19. MontoA, Alonzo J, Watson JJ, et al.: Steatosis in chronic hepatitis C: relative contributions of obesity, diabetes mellitus, and alcohol. Hepatology 2002, 36:729–736. A total of 297 patients with chronic hepatitis C were analyzed for host and viral factors related to steatosis and fibrosis.

    Article  PubMed  Google Scholar 

  20. Westin J, Nordlinder H, Lagging M, et al.: Steatosis accelerates fibrosis development over time in hepatitis C virus genotype 3 infected patients. J Hepatol 2002, 37:837–842.

    Article  PubMed  Google Scholar 

  21. Poynard T, Ratziu V, McHutchison J, et al.: Effect of treatment with peginterferon or interferon alfa-2b and ribavirin on steatosis in patients infected with hepatitis C. Hepatology 2003, 38:75–85. Assessed the effect of treatment on viral steatosis. In patients with HCV genotype 3 infection, sustained disappearance of the virus is associated with reduction of steatosis.

    Article  PubMed  CAS  Google Scholar 

  22. Castéra L, Hézode C, Roudot-Thoraval F, et al.: Worsening of steatosis is an independent factor of fibrosis progression in untreated patients with chronic hepatitis C and paired liver biopsies. Gut 2003, 52:288–292.

    Article  PubMed  Google Scholar 

  23. Asselah T, Boyer N, Guimont MC, et al.: Liver fibrosis is not associated with steatosis but with necroinflammation in French patients with chronic hepatitis C. Gut 2003, in press. Controversy about the role of steatosis in fibrosis progression is reported.

  24. Rubbia-Brandt L, Fabris P, Paganin S, et al.: Steatosis affects chronic hepatitis C progression in a genotype-specific way. Gut 2003, in press. A total of 755 patients with chronic hepatitis C were studied and only viral steatosis (HCV genotype 3) was found to be associated with fibrosis progression.

  25. Mehta SH, Brancati FL, Strathdee SA, et al.: Hepatitis C virus infection and incident type 2 diabetes. Hepatology 2003, 38:50–56.

    Article  PubMed  Google Scholar 

  26. Asselah T, Martinot M, Cazals-Hatem D, et al.: Hypervariable region 1 quasispecies in hepatitis C virus genotypes 1b and 3 infected patients with normal and abnormal alanine aminotransferase levels. J Viral Hepat 2002, 9:29–35.

    Article  PubMed  CAS  Google Scholar 

  27. McGuinness PH, Bishop GA, Painter DM, et al.: Intrahepatic hepatitis C RNA levels do not correlate with degree of liver injury in patients with chronic hepatitis C. Hepatology 1996, 23:676–687.

    Article  PubMed  CAS  Google Scholar 

  28. Boyer N, Marcellin P: Pathogenesis, diagnosis and management of hepatitis C. J Hepatol 2000, 32:98–112.

    Article  PubMed  CAS  Google Scholar 

  29. Rubbia-Brandt L, Giostra E, Mentha G, et al.: Expression of liver steatosis in hepatitis C virus infection and pattern of response to alpha interferon. J Hepatol 2001, 35:307.

    Article  PubMed  CAS  Google Scholar 

  30. Rubbia-Brandt L, Leandro G, Spahr L, et al.: Liver steatosis in chronic hepatitis C: a morphological sign suggesting infection with HCV genotype 3. Histopathology 2001, 39:119–124.

    Article  PubMed  CAS  Google Scholar 

  31. Kumar D, Farrell GC, Fung C, George J: Hepatitis C virus genotype 3 is cytopathic to hepatocytes: reversal of hepatic steatosis after sustained therapeutic response. Hepatology 2002, 36:1266–1272.

    Article  PubMed  Google Scholar 

  32. Marcellin P, Asselah T, Boyer N: Fibrosis and disease progression in hepatitis C. Hepatology 2002, 36:47–56.

    Article  Google Scholar 

  33. Ortiz V, Berenguer M, Rayón JM, et al.: Contribution of obesity to hepatitis C-related fibrosis progression. Am J Gastroenterol 1997, 9:2408–2414.

    Google Scholar 

  34. Friedenberg F, Pungpapong S, Zaeri N, Braitman LE: The impact of diabetes and obesity on liver histology in patients with hepatitis C. Diabetes Obes Metab 2003, 5:150–155.

    Article  PubMed  CAS  Google Scholar 

  35. Hickman IJ, Clouston AD, Macdonald GA, et al.: Effect of weight reduction on liver histology and biochemistry in patients with chronic hepatitis C. Gut 2002, 51:89–94.

    Article  PubMed  CAS  Google Scholar 

  36. Teli MR, Day CP, Burt AD, et al.: Determinants of progression to cirrhosis or fibrosis in pure alcoholic fatty liver. Lancet 1995, 346:987–990.

    Article  PubMed  CAS  Google Scholar 

  37. Iturriaga H, Bunout D, Hirsch S, Ugarte G: Overweight as a risk factor or a predictive sign of histological liver damage in alcoholics. Am J Clin Nutr 1988, 47:235–238.

    PubMed  CAS  Google Scholar 

  38. Ratziu V, Giral P, Charlotte F, et al.: Liver fibrosis in overweight patients. Gastroenterology 2000, 118:1117–1123.

    Article  PubMed  CAS  Google Scholar 

  39. Ghany MG, Kleiner DE, Alter H, et al.: Progression of fibrosis in chronic hepatitis C. Gastroenterology 2003, 124:97–104.

    Article  PubMed  Google Scholar 

  40. Neuman MG, Benhamou JP, Malkiewicz IM, et al.: Kinetics of serum cytokines reflect changes in the severity of chronic hepatitis C presenting minimal fibrosis. J Viral Hepat 2002, 9:134–140.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Service d’Hépatologie, Hôpital Beaujon, 100 Boulevard du Gén éral Leclerc, 92110, Clichy, France

    Patrick Marcellin MD

Authors
  1. Tarik Asselah MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nathalie Boyer MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Patrick Marcellin MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Asselah, T., Boyer, N. & Marcellin, P. Steatosis in hepatitis C: What does it mean?. Curr hepatitis rep 2, 137–144 (2003). https://doi.org/10.1007/s11901-003-0015-0

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11901-003-0015-0

Keywords

Search

Navigation