Liu Chun-Jen, Jeng Yung-Ming, Chen Pei-Jer, Lai Ming-Yang, Yang Hung-Chih, Huang Wen-Ling, Kao Jia-Horng, Chen Ding-Shinn
Division of Gastroenterology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Antivir Ther. 2005;10(3):405-15.
BACKGROUND/AIMS: The prevalence and clinical implications of non-alcoholic fatty liver disease in patients with chronic hepatitis C remain unknown in Taiwan.
We addressed the relevant issues by analysing 95 naive Taiwanese patients infected with either hepatitis C virus (HCV) genotype 1 (n = 57) or 2 (n = 38), receiving interferon alone (n = 41) or in combination with ribavirin (n=54) therapy. A single pathologist scored steatosis and steatohepatitis at baseline and 24 weeks after antiviral treatment.
At baseline, steatosis and steatohepatitis were present in 44 (46%) and four (4%) patients, respectively. Variables associated with steatosis in logistical regression were hyperglycaemia (P = 0.01), hypertriglyceridaemia (P = 004) and body mass index > or = 27 (P = 0.009), but not HCV genotype or viral load. The grade of steatosis correlated well with the number of metabolic syndrome parameters (P = 0.018). Interferon monotherapy, advanced age and HCV genotype 1, but not steatosis, correlated with lower sustained response rate. After treatment, steatosis improved in 19 and worsened in nine, which also did not correlate with HCV genotype (P = 0.850) or sustained response to antiviral therapy (P = 0.246).
Hepatic steatosis in Taiwanese patients with chronic hepatitis C was associated with features of the metabolic syndrome, but did not correlate with HCV genotype, advanced fibrosis or the response to antiviral therapy.
背景/目的：在台湾，慢性丙型肝炎患者中非酒精性脂肪性肝病的患病率及其临床意义尚不清楚。
我们通过分析95例初治的台湾患者来探讨相关问题，这些患者感染了丙型肝炎病毒（HCV）1型（n = 57）或2型（n = 38），单独接受干扰素治疗（n = 41）或联合利巴韦林治疗（n = 54）。由一名病理学家在基线和抗病毒治疗24周后对脂肪变性和脂肪性肝炎进行评分。
基线时，分别有44例（46%）和4例（4%）患者存在脂肪变性和脂肪性肝炎。逻辑回归中与脂肪变性相关的变量为高血糖（P = 0.01）、高甘油三酯血症（P = 0.04）和体重指数≥27（P = 0.009），但与HCV基因型或病毒载量无关。脂肪变性的程度与代谢综合征参数的数量密切相关（P = 0.018）。干扰素单药治疗、高龄和HCV 1型与较低的持续应答率相关，但与脂肪变性无关。治疗后，19例患者的脂肪变性有所改善，9例患者的脂肪变性恶化，这也与HCV基因型（P = 0.850）或抗病毒治疗的持续应答（P = 0.246）无关。
台湾慢性丙型肝炎患者的肝脂肪变性与代谢综合征特征相关，但与HCV基因型、严重肝纤维化或抗病毒治疗反应无关。
