Evolution of hepatic steatosis in patients with advanced hepatitis C: Results from the hepatitis C antiviral long-term treatment against cirrhosis (HALT-C) trial
Lok, Anna Suk-Fong; Everhart, James E.; Chung, Raymond T.; Kim, Hae-Young; Everson, Gregory T.; Hoefs, John C.; Greenson, Joel K.; Sterling, Richard K.; Lindsay, Karen L.; Lee, William M.; Di Bisceglie, Adrian M.; Bonkovsky, Herbert L.; Ghany, Marc G.; Morishima, Chihiro
2009-06
Citation
Lok, Anna S.; Everhart, James E.; Chung, Raymond T.; Kim, Hae-Young; Everson, Gregory T.; Hoefs, John C.; Greenson, Joel K.; Sterling, Richard K.; Lindsay, Karen L.; Lee, William M.; Di Bisceglie, Adrian M.; Bonkovsky, Herbert L.; Ghany, Marc G.; Morishima, Chihiro (2009). "Evolution of hepatic steatosis in patients with advanced hepatitis C: Results from the hepatitis C antiviral long-term treatment against cirrhosis (HALT-C) trial Potential conflict of interest: Financial relationships of the authors with Hoffmann-La Roche, Inc., are as follows: A.S. Lok is a consultant; R. T. Chung receives research support; G.T. Everson is a consultant, on the speaker's bureau, and receives research support; J.C. Hoefs is on the speaker's bureau; R.K. Sterling is a consultant, on the speaker's bureau, and receives research support; K.L. Lindsay is a consultant and receives research support. W.M. Lee receives research support; A.M. Di Bisceglie is a consultant, on the speaker's bureau, and receives research support; H.L. Bonkovsky receives research support. Authors with no financial relationships related to this project are: J.E. Everhart, H-Y Kim, J.K. Greenson, M.G. Ghany, and C. Morishima. ." Hepatology 49(6): 1828-1837. <http://hdl.handle.net/2027.42/63058>
Abstract
Hepatic steatosis is a common histologic feature in patients with chronic hepatitis C (CHC) but there are no large longitudinal studies describing the progression of steatosis in CHC. We examined changes in steatosis on serial biopsies among CHC patients participating in the Hepatitis C Antiviral Long-term Treatment against Cirrhosis (HALT-C) Trial. All 1050 patients in the trial had advanced fibrosis at baseline biopsy and were documented not to have had a sustained virological response to peginterferon and ribavirin. Most (94%) patients had genotype 1 infection. At least one protocol follow-up biopsy was read on 892 patients, and 699 had the last biopsy performed 3.5 years after randomization. At enrollment, 39% had cirrhosis and 61% had bridging fibrosis; 18%, 41%, 31%, and 10% had steatosis scores of 0, 1, 2, and 3 or 4, respectively. The mean steatosis score decreased in the follow-up biopsies in both the interferon-treated patients and controls with no effect of treatment assignment ( P = 0.66). A decrease in steatosis score by ≥1 point was observed in 30% of patients and was associated with both progression to cirrhosis and continued presence of cirrhosis ( P = 0.02). Compared to patients without a decrease in steatosis, those with a decrease in steatosis had worse metabolic parameters at enrollment, and were more likely to have a decrease in alcohol intake, improvement in metabolic parameters, and worsening liver disease (cirrhosis, esophageal varices, and deterioration in liver function). Conclusion: Serial biopsies demonstrated that in patients with CHC, steatosis recedes during progression from advanced fibrosis to cirrhosis. Decreased alcohol intake and improved metabolic parameters are associated with a decline in steatosis and may modulate hepatitis C progression. (H EPATOLOGY 2009.)Publisher
Wiley Subscription Services, Inc., A Wiley Company
ISSN
0270-9139 1527-3350
Other DOIs
PMID
19291787
Types
Article
Metadata
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