ISSN: 1300-0292
İndekslendiği Dizinler: SCIENCE CITATION INDEX EXPANDED
CINAHL, Index Copernicus,
Chemical Abstracts (CA),
Excerpta Medica / EMBASE
Dil: Türkçe, İngilizce
İçerik: Orijinal Araştırma, Derleme, Editöre Mektup, Olgu Sunumu, Tıp Eğitimi, Tıbbi Kitap İncelemeleri
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ORIGINAL RESEARCH ARTICLES |
Viral And Host Factors Of Liver Steatosis Associated With Chronic C Hepatitis And Effect Of Steatosis On Antiviral Treatment
Dr. Seyfettin KÖKLÜ,a Dr. Bahattin ÇİÇEK,a Dr. Osman YÜKSEL,a Dr. Zeki M.Y. KILIÇa
aGastroenteroloji Bölümü, Türkiye Yüksek İhtisas Hastanesi, ANKARA
Objective: To investigate the role of host and viral factors in the progression of liver steatosis in hepatitis C virus infection, and to evaluate the impact of steatosis on the response to antiviral therapy.
Material and Methods: We retrospectively analyzed 136 treatment-naive patients who had received a diagnosis of chronic hepatitis C between 1994 and 2002. Patients were divided into three groups according to the grade of steatosis on liver biopsy: None (<5%), mild (5%-29%) and severe (>30%) steatosis. The groups were compared for host (body mass index, alcohol consumption, diabetes mellitus and serum lipid levels) and viral (genotype and load) factors. Biopsy specimens were assessed for steatosis, necroinflammatory activity and fibrosis. Influence of steatosis on the response to antiviral therapy was investigated.
Results: Steatosis was present in 85 (62.5%) of the 136 subjects; 57 (41.9%) mild and 28 (20.6%) severe steatosis. Steatosis correlated with body mass index (p< 0.05). The prevalence of oral glucose intolerance was higher in patients with steatosis (p< 0.05). There was no association between steatosis and sex, age, alcohol consumption, diabetes mellitus, serum lipid levels, liver biochemical tests and histopathological findings. Grade of steatosis was not correlated with viral load. When patients with risk factors for hepatosteatosis (body mass index ³27, diabetes mellitus, alcohol consumption, serum triglycerides level >170 mg/dL) were excluded, 29 (58%) of the remaining 50 patients had steatosis. Prevalence of sustained response to combined therapy (interferon + ribavirin) was similar in groups with and without steatosis (50% and 54% respectively). However, the prevalence of sustained response to monotherapy (interferon) was lower in the steatosis group compared to the group without steatosis (25% versus 38.4%, p< 0.05).
Conclusion: Steatosis is frequent in chronic C hepatitis. Viral factors may influence liver steatosis as well as host factors. Steatosis seems not to affect the treatment response to combined therapy.Keywords: Hepacivirus, hepatitis C, fatty liverTurkiye Klinikleri J Med Sci 2006, 26:9-14
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