Effect of Obesity on Disease Progression and Response to Antiviral Treatment in HCV Genotype 4 Patients

Background and Study Aims: Egypt has one of the highest prevalence of hepatitis C virus (HCV) worldwide. Steatosis and high body mass index (BMI) may be associated with disease progression in patients with chronic HCV. The aim of this study was to determine the relationship between obesity defined according to body mass index and response to Pegylated Interferon (IFN) and Ribavirin (RBV) combination therapy in chronic hepatitis C Egyptian patients with genotype 4.

Methods: This retrospective study was conducted on 100 patients with chronic HCV who were candidates for IFN based therapy (PEG-IFN and RBV) from Jan. 2008 to June 2010 at National Hepatology Research Institute, Egypt. All patients were subjected to clinical examination, laboratory investigations, abdominal ultrasonography and liver biopsy. Data analysis was used to reveal whether high BMI was a variable related to treatment non response.

Results: All patients were classified into two groups according to BMI (non obese, <30 kg/m2; obese, ≥30 kg/ m2). It showed no significant difference in response to treatment according to BMI (P= 0.1). BMI at cut off 33.5 kg/m2 can predict presence of significant fibrosis (› F3) with a sensitivity and specificity of 68.4% and 80.6% respectively with AUC 0.79. Hepatic steatosis was not a risk factor for non response to antiviral treatment.

Conclusions: Our data suggest that obesity, when BMI ≥30 kg/m2, is not an independent risk factor for impaired response to hepatitis C treatment. While obesity is a predictor of fibrosis progression in patients with chronic hepatitis C.