Pathogenesis and significance of hepatitis C virus steatosis: An update on survival strategy of a successful pathogen

Table 2 Steatosis is associated with poor treatment outcome

Method and findings	Conclusion	Ref.
574 patients with chronic hepatitis C	Steatosis reduces the likelihood of achieving early and SVR in genotype 1 infected patients	[96]
HCV genotype 2 and 3 patients	Steatosis is the independent predictor of relapse	[102]
148 consecutive adults with HCV admitted for liver biopsy	Steatosis in chronic hepatitis C is not a negative prognostic factor of response to combined antiviral therapy	[103]
932 patients infected with HCV genotype 2 or 3	Steatosis was associated with significantly higher rates of relapse, irrespective of viral load, in patients infected with HCV genotype 3 who had an RVR	[104]
A total of 116 patients [HCV-G4 85 (73.3%); HCV-G1 31 (26.7%)] were included	The NAS steatosis score correlates with response to antiviral therapy	[105]
885 HCV patients	Steatosis did not influence the efficacy of treatment in our study population. Baseline viral load is a confounding factor, particularly in patients infected with genotype 3 and once baseline viral load was accounted for, the association between steatosis and SVR was not relevant	[106]
250 patients with genotype 4 chronic hepatitis C, treated with different regimens of combined interferon	Among genotype 4 chronic hepatitis C patients, severe fibrosis, severe steatosis, treatment with standard interferon and a high serum AFP level were all negatively associated with SVR	[107]
207 HCV patients	Features of the metabolic syndrome are associated with hepatic steatosis in most of these patients. Steatosis is significantly more common in genotype 3 compared with other genotypes, and in these patients, an SVR is associated with steatosis clearance	[108]
357 HCV-infected US veterans	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 alpha-2b and ribavirin treatment	[109]
80 Japanese patients with CHC. treated with IFN alpha-2b and ribavirin for 24 wk evaluated retrospectively	HS is an important predictor of poor response to therapy of IFN-alpha-2b and ribavirin in patients with CHC	[110]
Liver specimens with both CHC and significant steatosis (> 33%) or SH were categorized as group 1 (84 specimens). A control group (group 2) of 231 CHC patients without evidence of steatosis > 33% or SH	Overall SVR for patients with HCV and significant steatosis or SH is considerably lower than for HCV and steatosis less than 33% and no SH	[111]

CHC: Chronic hepatitis C; IFN: Interferon; NAS: Nonalcoholic fatty live disease activity score; RVR: Rapid virologic response; SH: Steatohepatitis; SVR: Sustained virologic response; AFP: Alpha fetoprotein; HCV: Hepatitis C virus; NASH: Non-alcoholic steatohepatitis.