Esmat G, El Akel Wafaa, Metwally M, Soliman A, Doss W, Hamid M Abdel, Kamal M, Zalata K, Khattab H, El-Kassas M, Esmat M, Hasan A, El-Raziky M
Hepatology and Tropical Medicine Department, Cairo University, Cairo, Egypt.
Indian J Gastroenterol. 2009 Mar-Apr;28(2):45-8. doi: 10.1007/s12664-009-0016-1. Epub 2009 Aug 21.
Hepatic steatosis is common in patients with chronic hepatitis C virus (HCV) infection, and its occurrence may be related to both host and viral factors. Relationship between improvement in steatosis and response to anti-viral treatment remains unclear. This study assessed the factors associated with steatosis in patients infected with genotype 4 HCV, and to correlate degree of changes in steatosis with host factors and response to treatment.
Records of 175 patients with chronic genotype 4 HCV infection, who had received interferon and ribavirin combination therapy, were reviewed retrospectively to extract data on body mass index (BMI), presence of diabetes mellitus, and liver histology findings. Paired BMI data and liver biopsies (pre- and 24-weeks post-treatment) were available in 86 patients. Baseline steatosis and its changes (before and after treatment) were the dependent variables in a univariate and multivariate analyses.
Steatosis was found in 88/175 (50.3%) of baseline biopsies. Its presence was related to baseline BMI (r=0.33, P<0.01), but not with viral load, or grade of liver inflammation or fibrosis. On follow up, improvement in steatosis was significantly associated with degree of weight loss but not with response to anti-viral treatment.
Steatosis is common in genotype 4 HCV infection, and its presence appears to be related to high BMI, but not to viral load or degree of liver injury.
肝脂肪变性在慢性丙型肝炎病毒（HCV）感染患者中很常见，其发生可能与宿主和病毒因素有关。脂肪变性的改善与抗病毒治疗反应之间的关系仍不清楚。本研究评估了感染基因4型HCV患者中与脂肪变性相关的因素，并将脂肪变性的变化程度与宿主因素及治疗反应相关联。
回顾性分析175例接受干扰素和利巴韦林联合治疗的慢性基因4型HCV感染患者的记录，以提取体重指数（BMI）、糖尿病的存在情况及肝脏组织学检查结果等数据。86例患者有配对的BMI数据和肝活检（治疗前及治疗后24周）。单因素和多因素分析中，基线脂肪变性及其变化（治疗前后）为因变量。
88/175（50.3%）的基线活检发现有脂肪变性。其存在与基线BMI相关（r = 0.33，P < 0.01），但与病毒载量、肝脏炎症或纤维化程度无关。随访时，脂肪变性的改善与体重减轻程度显著相关，但与抗病毒治疗反应无关。
基因4型HCV感染中脂肪变性常见，其存在似乎与高BMI有关，但与病毒载量或肝损伤程度无关。
