Steatosis, steatohepatitis: Review of effects on chronic hepatitis C

Hepatitis C remains a serious progressive chronic liver disease in spite of improvements in therapy. Numerous studies have investigated viral factors and host conditions that relate to progression of fibrosis to cirrhosis, response to therapy, and recurrence in allografts. Steatosis has long been recognized as a common histologic finding in hepatitis C; recent evidence suggests that steatosis in hepatitis C is not necessarily an incidental finding, and may be due to a variety of viral cytopathic effects, synergistic mechanisms of viral proteins with host lipid metabolism, or host factors that are also known to relate to steatosis and steatohepatitis in nonalcoholic fatty liver disease: visceral obesity, type 2 diabetes, and metabolic disorders of insulin resistance and lipid metabolism. Steatosis has also been implicated as a factor related to, or known to be associated with, progression of fibrosis, variability of therapeutic response, and recurrence in transplanted livers in patients with chronic hepatitis C. This article discusses the recent literature of this evolving field.