Hepatitis C and Nonalcoholic Fatty Liver Disease
Hepatitis C and Nonalcoholic Fatty Liver Disease
Hepatitis C virus (HCV) and nonalcoholic fatty liver disease (NAFLD) are the two most common causes of chronic liver disease in North America. NAFLD represents a spectrum of liver lesions that occur in individuals who either do not consume any alcohol or only consume alcohol in quantities generally considered not to be harmful to the liver. This spectrum consists of isolated hepatic macrovesicular steatosis at one end and nonalcoholic steatohepatitis (NASH) at the other. Hepatic steatosis is present in ~50% of the subjects with HCV. Genotype 3 is independently associated with hepatic steatosis. In those with genotype 1 infection, steatosis is associated with features of the metabolic syndrome. The presence of hepatic steatosis correlates with the stage of hepatic fibrosis in patients with HCV. This has been related to the presence of insulin resistance. Hepatic steatosis also adversely affects the virologic response rates to anti-HCV therapy. In this article, we will review the epidemiology of HCV and NAFLD, their impact on each other, and the course of the liver disease in individuals afflicted with both conditions.
Gastrointestinal and liver diseases inflict a heavy burden on the health and well being of Americans. Compelling economic data indicate that liver disease in general and hepatitis C in particular is a major liver-related public health problem. Approximately 1.8% of the general population in North America has active HCV, according to estimates, and, in specific subsets of the population, for example, African American males, the prevalence may be as high as 3.2%. HCV is also the leading cause of liver-related mortality in North America.
Hepatic steatosis is frequently seen in subjects with HCV. Recently, the presence and severity of hepatic steatosis has emerged as an important marker of progressive liver disease as well as virologic response to anti-HCV therapy. In most cases, the degree of steatosis is related to the concomitant presence of the metabolic syndrome, which is often accompanied by nonalcoholic fatty liver disease (NAFLD), another common cause of liver-related morbidity in the general population. In this article, we will review the epidemiology of HCV and NAFLD, their impact on each other, and the course of the liver disease in individuals afflicted with both conditions.
Hepatitis C virus (HCV) and nonalcoholic fatty liver disease (NAFLD) are the two most common causes of chronic liver disease in North America. NAFLD represents a spectrum of liver lesions that occur in individuals who either do not consume any alcohol or only consume alcohol in quantities generally considered not to be harmful to the liver. This spectrum consists of isolated hepatic macrovesicular steatosis at one end and nonalcoholic steatohepatitis (NASH) at the other. Hepatic steatosis is present in ~50% of the subjects with HCV. Genotype 3 is independently associated with hepatic steatosis. In those with genotype 1 infection, steatosis is associated with features of the metabolic syndrome. The presence of hepatic steatosis correlates with the stage of hepatic fibrosis in patients with HCV. This has been related to the presence of insulin resistance. Hepatic steatosis also adversely affects the virologic response rates to anti-HCV therapy. In this article, we will review the epidemiology of HCV and NAFLD, their impact on each other, and the course of the liver disease in individuals afflicted with both conditions.
Gastrointestinal and liver diseases inflict a heavy burden on the health and well being of Americans. Compelling economic data indicate that liver disease in general and hepatitis C in particular is a major liver-related public health problem. Approximately 1.8% of the general population in North America has active HCV, according to estimates, and, in specific subsets of the population, for example, African American males, the prevalence may be as high as 3.2%. HCV is also the leading cause of liver-related mortality in North America.
Hepatic steatosis is frequently seen in subjects with HCV. Recently, the presence and severity of hepatic steatosis has emerged as an important marker of progressive liver disease as well as virologic response to anti-HCV therapy. In most cases, the degree of steatosis is related to the concomitant presence of the metabolic syndrome, which is often accompanied by nonalcoholic fatty liver disease (NAFLD), another common cause of liver-related morbidity in the general population. In this article, we will review the epidemiology of HCV and NAFLD, their impact on each other, and the course of the liver disease in individuals afflicted with both conditions.
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