African Americans with Genotype 1 Hepatitis C Less Likely to Have Steatosis

Hepatic steatosis (fat accumulation in the liver) is common in patients with chronic hepatitis C, and has been linked to obesity, insulin resistance, diabetes, liver disease severity, and poor response to interferon-based therapy.

It is well established that African Americans respond more poorly to interferon-based therapy compared with Caucasians. Racial differences in rates of obesity and diabetes may contribute to differences in rates of steatosis and treatment response.

The aim of the present study, published in the January 2007 issue of Hepatology, was to compare rates of hepatic steatosis in African American and Caucasian American patients with chronic genotype 1 hepatitis C who participated in a prospective clinical trial of pegylated interferon plus ribavirin.

Liver biopsy results were available for 194 African American and 205 Caucasian patients.

Results

• 61% of the African American patients and 65% of the Caucasian patients had liver steatosis (P = 0.38).

• In a univariate analysis, steatosis was associated with the following factors:
- HOMA-IR insulin resistance score;
- body mass index;
- waist circumference;
- serum triglyceride level;
- aminotransferase (ALT and AST) levels;
- histological scores for liver inflammation and fibrosis.

• After adjusting for these factors, African American patients had a lower risk of steatosis than Caucasian patients (OR 0.54; P = 0.02).

• Insulin resistance but not steatosis was associated with a lower rate of sustained virological response after adjusting for known factors that predict treatment response (P = 0.028).

Conclusion

In conclusion, the authors wrote, "After adjusting for the higher prevalence of features associated with hepatic steatosis, African American patients had a lower prevalence of hepatic steatosis than did Caucasian patients with chronic hepatitis C, genotype 1. Insulin resistance but not steatosis was independently associated with lower sustained virological response."

01/05/07

Reference
H S Conjeevaram, D E Kleiner, J E Everhart, and others. Race, insulin resistance, and hepatic steatosis in chronic hepatitis C. Hepatology 45(1): 80-87. January 2007.