Endocrine Abstracts

Introduction: Steatosis has become an important issue in hepatitis C, due to the injury it can cause in a chronically ill liver. In chronic hepatitis C patients, the prevalence of steatosis ranges from 40–86%. Steatosis was significantly associated with the lack of response using PEG-IFN and ribavirin. The aim of our study was to determine the prevalence of hepatic steatosis in chronic hepatitis C and determine its impact on the therapeutic response using new direct antiviral agents (DAA).

Material and methods: This is a retrospective study conducted in the Hepatogastroenterology and Infectious Diseases Departments of Farhat Hached University Hospital, collecting all patients with chronic hepatitis C treated with DAA between October 2016 and May 2018. Steatosis was diagnosed by abdominal ultrasound. Treatment efficacy was assessed by the early virological response rate (EVR) at 4 weeks after the start of treatment and the sustained virological response rate (SVR) at 12 weeks after the end of treatment.

Results: Fifty four patients with a median age of 52 years, divided into 32 women and 22 men, were included. Non-insulin-dependent diabetes, portal hypertension and dyslipidemia were present in 13, 7 and 4 patients, respectively. The clinical manifestations were dominated by arthralgia and asthenia. Genotype 1b was dominant with a frequency of 76%. The average pretreatment viral load was 1 457 542 IU/ml. Fourteen patients (28%) were in the cirrhosis stage. Steatosis was present in 11 patients (20.3%). The duration of treatment was 12 weeks in 37 patients (74%) and 24 weeks in the remaining 13 patients (26%). An early virological response (EVR) was obtained in 71% of cases. A sustained virological response (SVR) was noted in all patients. EVR and SVR rates were comparable between patients with and without steatosis.

Conclusion: Steatosis was present in 20.3% of patients and it does not influence the response to treatment with direct antiviral agents.