Insulin resistance and liver steatosis in chronic hepatitis C infection genotype 3

Hepatitis C virus (HCV) infection is a common chronic liver diseaseworldwide. Non-alcoholic fatty liver disease and insulin resistance (IR) are the major determinants of fibrosis progression and response to antiviral therapy. The pathogenetic link between IR and chronic HCV infection is complex, and is associated with HCV genotype. Liver steatosisis the most common in the patients infected with genotype 3 virus, possibly due to direct effects of genotype 3 viral proteins. To the contrary, hepatic steatosisin the patients infected with other genotypes is thought to be mostly due to the changes in host metabolism, involving IR. In HCV genotype3, liver steatosiscorrelates with viral load, reverts after reaching the sustained virologic response and reoccurs in the relapsers. A therapeutic strategy to improve IR and liver steatosisand subsequently the response to antiviral treatment in these patients is warranted.