Clinical–liver, pancreas, and biliary tractRelationship Between Steatosis, Inflammation, and Fibrosis in Chronic Hepatitis C: A Meta-Analysis of Individual Patient Data
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Patients
Collection of CHC patient data was performed at 10 centers from Italy, Switzerland, France, Australia, and the United States. Patients were recruited consecutively for clinical management of their hepatitis C virus (HCV) infection, including the assessment of the indication to antiviral therapy, but were not involved primarily in clinical treatment trials. To be included in the HCV Meta-Analysis (on) Individual patients’ Data Study Group database, patients had to fulfill the following basic
Results
The baseline characteristics of the 3068 patients included in the study population are shown in Table 1. There were 1999 men (65.2%) with a mean age of 44.7 ± 11.8 years, and an average BMI of 25.4 ± 3.9 kg/m2. According to the previously described definitions, alcohol abuse at the time of liver biopsy examination was reported by 370 persons (12.1%), whereas 737 (24.0%) had a history of long-lasting excess alcohol drinking in the past. Diabetes was present in 194 patients (6.3%). Overall, HCV
Discussion
Progression of CHC depends significantly on host and environmental factors. Given that currently available antiviral regimens induce a sustained virologic response in only approximately 60% of patients, and that individuals with advanced liver disease may not benefit from therapy, medical interventions often are limited to correcting cofactors associated with liver-related morbidity.
Steatosis has been suggested as an important cofactor for liver fibrosis. However, there is not a clear consensus
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Supported by grants 3200-63549.00 and 3200B0-103727 from the Swiss National Science Foundation, Berne, Switzerland (to F.N.); DK56402 from the National Institutes of Health, Bethesda, Maryland (to The University of Sydney Hepatitis C Pathogenesis Study Group and to J.G.); grants from the French Agency for Acquired Immune Deficiency Syndrome Research (ANRS), Paris, France (to T.A., P.M.); grant 2004061213-006 from the Ministero dell’Istruzione, Universita’ e Ricerca Scientifica, Rome, Italy (to L.E.A., G.R.); a grant from the Regione Campania, Naples, Italy (to L.E.A., G.R.); from the National Health and Medical Research Council, Canberra, Australia (to E.E.P., J.R.J.); from the Lions Medical Research Foundation, Brisbane, Australia (to J.R.J.); and R01 AA12879 from the National Institutes of Health–National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (to N.T.).