By Liz Highleyman

It is increasingly clear that hepatitis C virus (HCV) infection is associated with various metabolic complications including insulin resistance, but the effects of diet on liver fibrosis progression and response to interferon-based therapy have not been extensively studied.

As reported in the September 11, 2008 advance online edition of the American Journal of Gastroenterology, researchers from the University of Naples in Italy conducted a study to evaluate whether diet affects the severity of liver damage and response to therapy in patients with chronic hepatitis C.

The prospective study enrolled 1084 patients with biopsy-proven HCV-related chronic hepatitis -- of whom 432 were treated with interferon plus ribavirin -- and 2326 healthy HCV negative control subjects.

The investigators collected data on dietary habits and alcohol consumption. All participants underwent routine liver function tests and HCV genotyping, as well as assessment of body mass index and plasma levels of glucose, nitrogen, creatinine, cholesterol, and triglycerides.

Results

• At baseline, there were no differences in metabolic status or alcohol consumption between the HCV positive patients and HCV negative control subjects.

• About 50% of each group was overweight and about 60% consumed alcohol.

• HCV positive patients and HCV negative control subjects also had similar dietary habits.

• In a logistic regression analysis, intake of carbohydrates, lipids, and polyunsaturated fatty acids, as well as alcohol consumption, were independent risk factors for liver damage.

• In a univariate analysis, consumption of some dietary components -- including unsaturated fatty acids, iron, zinc, vitamin A, and niacin -- differed significantly between responders and non-responders to interferon-based therapy (P < 0.05).

• Alcohol consumption also differed significantly between responders and nonresponders (P = 0.01).

• In a multivariate analysis, HCV genotype, age, body mass index, liver steatosis (fat accumulation), and fibrosis were independent predictors of treatment response (P < 0.02).

"Our results show that dietary composition is related to the extent of liver damage," the study authors concluded. "Although traditional risk factors independently affected treatment response, some dietary components were associated with non-response to therapy in our patients."

"This suggests that HCV patients may benefit from instructions regarding their diet," they added.

9/16/08

Reference
C Loguercio, A Federico, M Masarone, and others. The impact of diet on liver fibrosis and on response to interferon therapy in patients with HCV-related chronic hepatitis. American Journal of Gastroenterology. September 11, 2008 [Epub ahead of print]. (Abstract).