Effect of weight reduction on liver histology and biochemistry in patients with chronic hepatitis C

Magnetic resonance imaging and spectroscopy for monitoring liver steatosis

“…In the subject with HCV genotype 3, in which the virus is considered to have a steatogenic effect, loss of 5% body weight resulted in a 79% reduction in steatosis to "normal levels." These results confirm earlier data regarding the beneficial effect of weight reduction on steatosis in patients with chronic HCV (7). In addition to loss of liver fat, weight loss led to a significant reduction in visceral and subcutaneous fat.…”

“…It was previously shown that in subjects with chronic HCV, a mean weight loss of 8.1% led to a decrease in steatosis, as assessed in paired liver biopsy specimens, with a median reduction of one grade on a four-point histological scale (7). In addition to concerns regarding sampling error, liver biopsy is invasive and cannot be performed repeatedly to monitor hepatic steatosis following treatment.…”

The diagnosis and management of non-alcoholic fatty liver disease: Practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association

“…More recent uncontrolled studies also showed an improvement in aminotransferases and hepatic steatosis on histology with lifestyle modification. [96][97][98] Orlistat (an enteric lipase inhibitor) in conjunction with lifestyle modification was investigated in two randomized controlled trials. In the study by ZieglerSagi et al, 99 orlistat reportedly improved ALT and steatosis by US, but its effect on liver histology could not be evaluated because the majority of patients did not undergo a follow-up liver biopsy.…”

Steatosis and Chronic Hepatitis C Infection: Mechanisms and Significance

“…Supportive evidence for a link between insulin-resistance hepatic steatosis and fibrosis is shown in a recent study that showed that weight loss in patients with CHC and steatosis improved insulin sensitivity and steatosis and fibrosis. 29 Pathophysiologic mechanisms explaining the relationship between insulin resistance, steatosis, and fibrosis development and progression are not understood fully, but likely involve both host and virally mediated factors. Overweight patients with visceral adiposity may develop fibrosis in a similar manner as NAFLD patients.…”