Curbside Consultation of the Liver: 49 Clinical Questions

Mitchell L. Shiffman, MD

Question 29: My Patient With Chronic Hepatitis C Also Has Evidence Of Nonalcoholic Steatohepatitis On His Liver Biopsy. What Can I Do To Increase His Chance Of Responding To Peginterferon And Ribavirin Treatment? (continued)

Arun J. Sanyal, MD; Onpang Cheung, MD, MPH

Hepatitis C virus (HCV) is one of the most common causes of chronic liver disease, affecting 130 million individuals worldwide and approximately 2.7 million Americans. Twenty percent of these patients will potentially progress to cirrhosis. Nonspecific histologic features of steatosis and Mallory body–like material within hepatocytes are seen in 30% to 70% of patients with chronic hepatitis C (CHC) and are thought to be related to both viral (HCV genotype 3) and host factors (conditions associated with the metabolic syndrome). Genotype 3 HCV directly produces hepatic steatosis by…