Editorial
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Oct 28, 2009; 15(40): 4993-4999
Published online Oct 28, 2009. doi: 10.3748/wjg.15.4993
Hepatitis C comorbidities affecting the course and response to therapy
Abdel-Rahman El-Zayadi
Abdel-Rahman El-Zayadi, Tropical Medicine Department, Ain Shams University and Cairo Liver Center, Giza 12311, Egypt
Author contributions: El-Zayadi AR solely contributed to this paper.
Correspondence to: Abdel-Rahman El-Zayadi, MD, Professor of Hepatogastroenterology, Tropical Medicine Department, Ain Shams University and Cairo Liver Center, 5, El-Gergawy St. Dokki, Giza 12311, Egypt. clcz@tedata.net.eg
Telephone: +20-2-37603002 Fax: +20-2-37481900
Received: April 22, 2009
Revised: September 5, 2009
Accepted: September 12, 2009
Published online: October 28, 2009
Abstract

Several studies have demonstrated that the outcome of chronic hepatitis C (CHC) infection is profoundly influenced by a variety of comorbidities. Many of these comorbidities have a significant influence on the response to antiviral therapy. These comorbidities negatively affect the course and outcome of liver disease, often reducing the chance of achieving a sustained virological response with PEGylated interferon and ribavirin treatments. Comorbidities affecting response to antiviral therapy reduce compliance and adherence to inadequate doses of therapy. The most important comorbidities affecting the course of CHC include hepatitis B virus coinfection, metabolic syndrome, and intestinal bacterial overgrowth. Comorbidities affecting the course and response to therapy include schistosomiasis, iron overload, alcohol abuse, and excessive smoking. Comorbidities affecting response to antiviral therapy include depression, anemia, cardiovascular disease, and renal failure.

Keywords: Comorbidities; Chronic hepatitis C; Response to therapy