RESUMO
UNLABELLED: Overweight/obesity is an independent negative predictive factor of steatosis in chronic hepatitis C virus infection. The nonresponse to combined peginterferon and ribavirin treatment in infection caused by genotype 1 is associated with the waist circumference, body mass index (BMI), diabetes, steatosis, and degree of fibrosis. The obesity is an independent negative predictive factor of inefficacy of antiviral treatment. CASE REPORT: The authors summarize the case of a 59-year-old obese (BMI = 46.47 kg/m 2 ) male patient with chronic HCV infection. The weight reduction--after two ineffective antiviral treatments--helped the biochemical and virological response to combined peginterferon-alpha-2a and ribavirin treatment. Between the combined peginterferon and ribavirin therapy, the patient was treated with amantadine and silymarin. DISCUSSION: The authors summarize the importance of steatosis and insulin resistance in chronic HCV hepatitis as well as review the impact of weight reduction and the improvement of insulin sensitivity. CONCLUSION: Body-weight reduction and hepatoprotective drugs might have increased the effectiveness of combined peginterferon and ribavirin treatment and thus the sustained virological response.