Nov 22, 2008
Current Hepatitis Reports
Hepatic steatosis is a frequent histologic finding in chronic hepatitis C (CHC) patients. Both host and viral factors contribute to steatogenesis. Recent literature has demonstrated the interaction of viral proteins with hepatic cellular components, resulting in oxidative stress, cytokine release, inflammation, insulin resistance, and disturbance in lipid and carbohydrate metabolism. These viral-induced hepatocellular abnormalities thus initiate development of steatosis, worsening fibrosis, poor therapeutic response, and carcinogenesis. Steatosis in hepatitis C appears to be genotype specific and is predominantly metabolic in genotype 1 and cytopathic in genotype 3. This review discusses the details of complex pathogenic mechanisms of steatosis in CHC patients. The impact of steatosis on the disease’s natural history is discussed, and future directions are outlined.