Patel Anish, Harrison Stephen A
Division of Gastroenterology and Hepatology, Department of Medicine, San Antonio Military Medical Center, Fort Sam Houston, Texas, USA.
Gastroenterol Hepatol (N Y). 2012 May;8(5):305-12.
Nonalcoholic fatty-liver disease (NAFLD) is one of the most prevalent liver diseases in the Western hemisphere. The rising rates of obesity and diabetes mellitus correlate with the increasing incidence of NAFLD, which is the hepatic manifestation of metabolic syndrome. Hepatitis C virus infection is another common cause of liver disease worldwide. Up to 70% of patients with chronic hepatitis C (CHC) will have concomitant steatosis. The presence of NAFLD has been implicated as a cause of lower viral response rates in CHC patients who are treated with pegylated interferon and ribavirin. This review will focus on the factors that lead to NAFLD in the setting of hepatitis C virus infection, including viral and host factors-in particular, inflammatory mediators, cytokines, and lipid peroxidation. This paper will also discuss the implications of NAFLD and nonalcoholic steatohepatitis regarding fibrosis progression, risk of hepatocellular carcinoma, and limitations with antiviral therapy.
非酒精性脂肪性肝病（NAFLD）是西半球最常见的肝脏疾病之一。肥胖症和糖尿病发病率的上升与NAFLD发病率的增加相关，NAFLD是代谢综合征的肝脏表现。丙型肝炎病毒感染是全球范围内另一个常见的肝脏疾病病因。高达70%的慢性丙型肝炎（CHC）患者会伴有脂肪变性。NAFLD的存在被认为是接受聚乙二醇化干扰素和利巴韦林治疗的CHC患者病毒反应率较低的一个原因。本综述将聚焦于丙型肝炎病毒感染情况下导致NAFLD的因素，包括病毒和宿主因素，特别是炎症介质、细胞因子和脂质过氧化。本文还将讨论NAFLD和非酒精性脂肪性肝炎在纤维化进展、肝细胞癌风险以及抗病毒治疗局限性方面的影响。
