What are the comorbidities influencing the management of patients and the response to therapy in chronic hepatitis C?
Article first published online: 21 JAN 2009
© 2009 John Wiley & Sons A/S
Special Issue: International Conference of the Management of Patients with Viral Hepatitis, Paris, 19-20 January 2009
Volume 29, Issue Supplement s1, pages 15–18, January 2009
How to Cite
Alberti, A. (2009), What are the comorbidities influencing the management of patients and the response to therapy in chronic hepatitis C?. Liver International, 29: 15–18. doi: 10.1111/j.1478-3231.2008.01945.x
- Issue published online: 21 JAN 2009
- Article first published online: 21 JAN 2009
- Received 1 November 2008Accepted 10 November 2008
- hepatitis C;
- insulin resistance
The natural history of chronic hepatitis C has been defined in several retrospective and prospective studies conducted in the last 20 years. These studies have clearly demonstrated that the outcome of chronic hepatitis C virus infection is profoundly influenced by a variety of cofactors and comorbidities. Many of the cofactors that affect the course of liver disease in hepatitis C also have a significant influence on the result of antiviral therapy. Unfortunately, comorbidities that have been shown to negatively influence the course and outcome of liver disease often reduce the chance of achieving a sustained virological response with pegylated interferon (PEG-IFN) and ribavirin treatment. The most important and frequent comorbidity influencing the course of chronic hepatitis C and the response to antiviral therapy is represented by the metabolic syndrome, and by the associated state of insulin resistance. Other comorbidities that have a negative influence on the progression of hepatitis C and on the response to antiviral therapy include excess alcohol intake, human immunodeficiency virus and hepatitis B virus co-infection and a number of conditions that reduce the benefit of therapy by affecting negatively compliance and/or adherence to adequate PEG-IFN or ribavirin doses.