About this Journal Submit a Manuscript Table of Contents
Gastroenterology Research and Practice
Volume 2012 (2012), Article ID 420156, 9 pages
http://dx.doi.org/10.1155/2012/420156
Research Article

The Impact of Host Metabolic Factors on Treatment Outcome in Chronic Hepatitis C

14th Department of Internal Medicine, Hippokration General Hospital of Thessaloniki, Medical School of Aristotle University, 54642 Thessaloniki, Greece
2Department of Internal Medicine, Infectious Diseases Hospital of Thessaloniki, Thessaloniki, Greece
32nd Department of Internal Medicine, Hippokration General Hospital of Athens, University of Athens Medical School, 11527 Athens, Greece
4Division of Gastroenterology, Department of Internal Medicine, University Hospital of Patras, 26504 Rio Patras, Greece

Received 31 October 2011; Revised 23 January 2012; Accepted 1 February 2012

Academic Editor: Edoardo G. Giannini

Copyright © 2012 Savvidou Savvoula et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Recent data suggest that chronic hepatitis C has to be considered a metabolic disease further to a viral infection. The aim of this study was to elaborate on the complex interactions between hepatitis C virus, host metabolic factors, and treatment response. Methods. Demographic, virological, and histological data from 356 consecutive patients were analyzed retrospectively. Hepatic steatosis, obesity, and insulin resistance were examined in relation to their impact on treatment outcome. Comparison between genotype 1 and 3 patients was performed to identify differences in the determinants of hepatic steatosis. Results. Histological evidence of hepatic steatosis was found in 113 patients, distributed in 20.3%, 9.0%, and 2.5% for grades I, II, and III, respectively. Hepatic steatosis was associated with past alcohol abuse ( 𝑃 = 0 . 0 0 3 ) and histological evidence of advanced fibrosis ( 𝑃 < 0 . 0 0 1 ). Older age (OR 2.51, 𝑃 = 0 . 0 0 2 ), genotype (OR 3.28, 𝑃 < 0 . 0 0 1 ), cirrhosis (OR 4.23, 𝑃 = 0 . 0 0 5 ), and hepatic steatosis (OR 2.48, 𝑃 = 0 . 0 0 1 ) were independent predictors for nonresponse. Correlations of hepatic steatosis with alcohol, insulin resistance, and fibrosis stage were found similar for both genotypes 1 and 3. Conclusions. Host metabolic factors may predict treatment outcome, and this impact remains significant even in genotype 3, where steatosis has been believed to be exclusively virus related.