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Semin Liver Dis 2004; 24(4): 399-413
DOI: 10.1055/s-2004-860869
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Hepatitis C and Nonalcoholic Fatty Liver Disease

Seela Ramesh1 , Arun J. Sanyal1 , 2
  • 1Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University Medical Center, Richmond, Virginia
  • 2Professor of Medicine
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Publication History

Publication Date:
16 December 2004 (online)

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ABSTRACT

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.

KEYWORDS

Hepatitis C - nonalcoholic fatty liver disease - nonalcoholic steatohepatitis - fatty liver - metabolic syndrome - insulin resistance - hepatic fibrosis - cirrhosis - virologic response

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Arun J SanyalM.D. 

Professor of Medicine, Pharmacology and Pathology

MCV Box 980341, Richmond

VA 23298-0341

Email: ajsanyal@hsc.vcu.edu