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 22 February 2018

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High body mass index is a risk factor for nonresponse to treatment in hepatitis C

Physicians from Canada find that obesity is an independent negative predictor of patients' response to hepatitis C treatment.

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The aim of this study, published in the latest issue of Hepatology, was to determine whether body mass index (BMI) predicts response to antiviral therapy for chronic hepatitis C.

A team of doctors performed a retrospective review of all patients with chronic hepatitis C treated with antiviral medication at a single center, between 1989 and 2000.

They defined a sustained response as either negative hepatitis C virus (HCV) RNA by PCR and/or a normal alanine aminotransferase (ALT) level 6 months after the completion of treatment.

The team divided patients into 3 groups according to their BMI. These were <25 kg/m2 (normal), 25 to 30 kg/m2 (overweight), and >30 kg/m2 (obese).

A total of 253 patients were treated with either interferon (IFN) monotherapy or IFN in combination with ribavirin.

Patients were excluded if predetermined clinical characteristics were unavailable.
Hepatic steatosis was not an independent risk factor for response to antiviral treatment.
Hepatology

The team used logistic regression to analyze the data.

After adjusting for several variables, they found that there were significant differences in the patients' response to treatment according to BMI group, virus genotype, and cirrhosis.

Patients with genotypes 2 or 3 had an odds ratio (OR) for success of 11.7 when compared with those with genotype 1.

In addition, the team determined that cirrhotic patients had an OR of 0.15 compared with noncirrhotic patients, and obese patients had an OR of 0.23 compared with normal and overweight patients.

However, the researchers did not find that hepatic steatosis was an independent risk factor for response to antiviral treatment.

Dr Brian Bressler's team concluded, "Obesity, only when defined as a BMI greater than 30 kg/m2, is an independent (of genotype and cirrhosis) negative predictor of response to hepatitis C treatment.

Hepatology 2003; 38: 639-44
04 September 2003

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