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World J Gastroenterol. Jun 21, 2014; 20(23): 7089-7103
Published online Jun 21, 2014. doi: 10.3748/wjg.v20.i23.7089
Pathogenesis and significance of hepatitis C virus steatosis: An update on survival strategy of a successful pathogen
Amedeo Lonardo, Luigi Elio Adinolfi, Luciano Restivo, Stefano Ballestri, Dante Romagnoli, Enrica Baldelli, Fabio Nascimbeni, Paola Loria
Amedeo Lonardo, Stefano Ballestri, Dante Romagnoli, Enrica Baldelli, Fabio Nascimbeni, Paola Loria, Division of Internal Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy
Luigi Elio Adinolfi, Luciano Restivo, Department of Medical, Surgical, Neurological, Metabolic, and Geriatric Sciences, Second University of Naples, 80100 Naples, Italy
Author contributions: Lonardo A and Adinolfi LE contributed equally to this paper by conceiving the idea of this review and writing the first draft of the manuscript; all the authors critically revised, edited and approved the submission.
Correspondence to: Amedeo Lonardo, MD, Division of Internal Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini 1355, 41126 Modena, Italy. a.lonardo@libero.it
Telephone: +39-59-3961807 Fax: +39-59-3961322
Received: September 27, 2013
Revised: January 17, 2014
Accepted: April 1, 2014
Published online: June 21, 2014
Core Tip

Core tip: Hepatitis C virus (HCV) steatosis occurs in the setting of multiple abnormalities collectively referred to as “hepatitis C-associated dysmetabolic syndrome”. General, nonalcoholic fatty liver disease-like, mechanisms of steatogenesis are shared by all HCV genotypes. However, genotype 3 seemingly amplifies such steatogenic molecular mechanisms. HCV steatosis has a remarkable clinical impact in accelerating fibrogenesis; impairing treatment response to interferons and ribavirin; and favouring the development of hepatocellular carcinoma and atherosclerosis. In conclusion, steatosis fulfills all expected requirements necessary to perpetuate the HCV life cycle and is associated with HCV infection by necessity rather than by chance.