Impact of obesity on treatment of chronic hepatitis C


  • Potential conflict of interest: Dr. Pockros is on the speakers' bureau for and received grants from Roche, Valeant, Bristol-Meyers-Squibb, and Gilead. He advises Roche and Valeant. Dr. Charlton is a consultant for Bristol-Meyers-Squibb and has received research funding from Roche.


Obesity and the metabolic syndrome have hepatic manifestations, including steatosis and progression of fibrosis. In individuals with chronic hepatitis C, obesity is associated with inflammation, insulin resistance, steatosis, progression of fibrosis, and nonresponse to treatment with interferon or peginterferon alpha and ribavirin. Patients with both hepatitis C and obesity-related nonalcoholic fatty liver disease are at greater risk for more advanced liver disease. We review the mechanisms by which obesity may be associated with decreased efficacy of interferon-based therapies in individuals with chronic hepatitis C and the therapeutic strategies that may increase the effectiveness of these therapies in obese individuals. (HEPATOLOGY 2006;43: 1177–1186.)