Prognostic impact of steatosis in the clinical course of chronic HCV infection-Results from the German Hepatitis C-Registry.

BACKGROUND

Liver steatosis is often observed in chronic HCV infection and associated to genotype or comorbidities. NAFLD is an important risk factor for end-stage liver disease. We aimed to analyse the course of NAFLD as a concomitant disease in a cohort of HCV patients.

METHODS

The German Hepatitis C-Registry is a national multicenter real-world cohort. In the current analysis, 8789 HCV patients were included and separated based on the presence of steatosis on ultrasound and/or histology. Fibrosis progression was assessed by transient elastography (TE), ultrasound or non-invasive surrogate scores.

RESULTS

At the time of study inclusion 12.3% (n = 962) of HCV patients presented with steatosis (+S) (higher rate in GT-3). Diabetes mellitus was more frequent in GT-1 patients. HCV patients without steatosis (-S) had a slightly higher rate of fibrosis progression (FP) over time (30.3%) in contrast to HCV patients +S (26%). This effect was mainly observed in GT-3 patients (34.4% vs. 20.6%). A larger decrease of ALT, AST and GGT from baseline to FU-1 (4-24 weeks after EOT) was found in HCV patients (without FP) +S compared to -S. HCV patients -S and with FP presented more often metabolic comorbidities with a significantly higher BMI (+0.58kg/m2) compared to patients -S without FP. This was particularly pronounced in patients with abnormal ALT.

CONCLUSION

Clinically diagnosed steatosis in HCV patients does not seem to contribute to significant FP in this unique cohort. The low prevalence of steatosis could reflect a lower awareness of fatty liver in HCV patients, as patients -S and with FP presented more metabolic risk factors.

Déclaration de conflit d'intérêts

The authors have read the journal’s policy and have the following competing interests: Peter Buggisch has the following competing interests: Sponsored lectures (national/international); Norgine, AbbVie, Falk, Gilead; Merz, MSD Advisory Committee or Review Panel: AbbVie, Gilead, MSD, Intercept Stefan Mauss Sponsored lectures: AbbVie, Gilead, Janssen, MSD Advisory Committee: AbbVie, Gilead, MSD, MYR Pharmaceuticals, ViiV Klaus H.W. Boeker none Hartwig Klinker Advisory Committee or Review Panel: AbbVie, Gilead, Hexal, Janssen, MSD, Shionogi, ViiV Grant/Research Support: Arrowhead, BMS, Hectorstiftung, MSD Speaking and Teaching: AbbVie, BMS, Janssen, MSD, Pfizer Tobias Müller none Albrecht Stoehr Sponsored lectures (national/international): Janssen, MSD, Gilead, ViiV, AbbVie; Advisory Committee or Review: Panel AbbVie, ViiV. Jörn M. Schattenberg has the following competing interests: Scientific Steering Committee: Madrigal; Consultancy: BMS, Boehringer Ingelheim, Echosens, Genfit, Gilead Sciences, Intercept Pharmaceuticals, Novartis, Pfizer, Roche; Research Funding: Gilead Sciences, Endra Life Sciences Inc., Siemens Healthcare GmbH; Speakers Bureau: Falk Foundation MSD Sharp & Dohme GmbH Andreas Geier Steering Committee: Gilead, Intercept, Novartis; Advisory Committee or Review: AbbVie, Alexion, BMS, Gilead, Intercept, Ipsen, Novartis, Pfizer, Sanofi-Aventis, Sequana; Speaking and Teaching: AbbVie, Alexion, BMS, CSL Behring, Falk, Gilead, Intercept, Merz, Novartis, Sequana; Grant/Research Support: Intercept (NAFLD CSG), Novartis, Kibion This does not alter our adherence to PLOS ONE policies on sharing data and materials. There are no patents, products in development or marketed products associated with this research to declare.