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Publication Name
World Journal of Hepatology
ISSN
1948-5182
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study
Copyright ©The Author(s) 2025.
World J Hepatol. Dec 27, 2025; 17(12): 113639
Published online Dec 27, 2025. doi: 10.4254/wjh.v17.i12.113639
Table 1 Baseline characteristics in the steatotic liver disease and non-steatotic liver disease groups, n (%)
Parameter
SLD (n = 290)
Non-SLD (n = 398)
P value
Age (years), median (Q1-Q3)54 (38-64)43.0 (35.0-62)0.0007
Age ≥ 50158 (54.5)166 (41.7)0.0009
Gender, women/men109 (37.2)/182 (62.8)235 (59.0)/163 (41.0)< 0.0001
BMI (kg/m2), median (Q1-Q3)26.5 (23.8-30)24.6 (22.3-27)< 0.0001
BMI ≥ 25 kg/m2181 (62.4)109 (27.4)< 0.0001
Comorbidities
Any comorbidity242 (83.4)291 (73.1)0.0014
Diabetes41 (14.1)32 (8.0)0.0103
Obesity75 (25.9)42 (10.6)< 0.0001
Autoimmune disorders18 (6.2)24 (6.0)0.9238
Arterial hypertension108 (37.2)131 (32.9)0.2392
Non-HCC tumors17 (5.9)30 (7.5)0.3896
Renal disease23 (7.9)38 (9.5)0.4613
Cholelithiasis61 (21.0)93 (23.4)0.4686
Hyperlipidemia50 (17.2)39 (9.8)0.0041
Concomitant medications192 (66.2)236 (59.3)0.0649
HBV coinfection (HBsAg+)1 (0.3)2 (0.5)0.7566
HIV coinfection2 (0.7)00.0971
IVDU current/past5 (1.7)9 (2.3)0.7866
Alcohol abuse in the past67 (23.1)15 (3.8)< 0.0001
SLD: Steatotic liver disease; Q: Quartile; BMI: Body mass index; HCC: Hepatocellular carcinoma; HBV: Hepatitis B virus; HBsAg: Hepatitis B surface antigen; HIV: Human immunodeficiency virus; IVDU: Intravenous drug use.
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Table 2 Share of steatotic liver disease among patients with risk factors, n (%)
Parameter
Arterial hypertension
Diabetes
Hyperlipidemia
Overweight + obesity
Alcohol
GT3
All/688239 (34.7)73 (10.6)89 (12.9)290 (42.2)82 (11.9)114 (16.6)
SLD108 (45.2)41 (56.2)50 (56.2)181 (56.2)67 (81.7)71 (62.3)
Non-SLD131 (54.8)32 (43.8)39 (43.8)109 (43.8)15 (18.3)43 (37.7)
P value0.03540.13630.0991< 0.0001< 0.00010.0002
GT3: Genotype 3; SLD: Steatotic liver disease.
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Table 3 Baseline laboratory parameters in the steatotic liver disease and non-steatotic liver disease groups, median (Q1-Q3)
Parameter
SLD (n = 290)
Non-SLD (n = 398)
P value
ALT (IU/L)71.0 (47-106)46 (32-76)< 0.0001
AST (IU/L)58.5 (40-95)38 (28-58)< 0.0001
GGTP (IU/L)67 (37-136)36.5 (20-71)< 0.0001
Albumin (g/dL)4.0 (3.6-4.4)4.1 (3.9-4.4)0.0028
Bilirubin (mg/dL)0.7 (0.6-1.1)0.6 (0.5-0.9)< 0.0001
Haemoglobin (g/dL)14.6 (13.2-15.6)14.2 (13.4-15.3)0.1461
Platelets (× 1000/μL)176 (108-223)198 (159-237)< 0.0001
Creatinine (mg/dL)0.8 (0.7-0.9)0.8 (0.7-0.9)0.9771
INR1.04 (1.00-1.18)1.00 (1.00-1.10)0.0001
HCV RNA (× 106 IU/mL)1.0 (0.3-2.5)0.9 (0.3-2.8)0.9636
Q: Quartile; SLD: Steatotic liver disease; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; GGTP: Gamma-glutamyl transpeptidase; INR: International normalized ratio; HCV: Hepatitis C virus; RNA: Ribonucleic acid.
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Table 4 Characteristics of antiviral therapy and liver disease in the steatotic liver disease and non-steatotic liver disease groups, n (%)
Parameter
SLD (n = 290)
Non-SLD (n = 398)
P value
GT371 (24.5)43 (10.8)< 0.0001
History of antiviral therapy0.0315
Treatment-naïve257 (88.6)380 (95.5)
Treatment-experienced, non-responder to IFN-based regimens19 (6.6)15 (3.8)
Treatment-experienced, non-responder to DAA regimens14 (4.8)3 (0.7)
Current treatment regimen< 0.0001
GLE/PIB127 (43.8)245 (61.6)
SOF/VEL ± RBV158 (54.5)153 (38.4)
SOF/VEL/VOX5 (1.7)0
History of hepatic decompensation
Ascites and/or encephalopathy25 (8.6)8 (2.0)0.0001
Ascites24 (8.3)8 (2)0.0002
Encephalopathy8 (2.7)2 (0.5)0.0209
Documented esophageal varices38 (13.1)17 (4.3)< 0.0001
Liver decompensation at baseline
Ascites and/or encephalopathy23 (7.9)9 (2.3)0.0005
Ascites23 (7.9)8 (2)0.0003
Encephalopathy11 (3.8)3 (0.8)0.0108
F4104 (35.8)48 (12)< 0.0001
Child-Pugh, in relation to F4
B + C30 (29.1)12 (25)0.0001
HCC10 (3.4)4 (1.0)0.0299
OLTx00NA
SLD: Steatotic liver disease; GT3: Genotype 3; IFN: Interferon; DAA: Direct-acting antiviral; GLE/PIB: Glecaprevir/pibrentasvir; SOF/VEL: Sofosbuvir/velpatasvir; SOF/VEL ± RBV: Sofosbuvir/velpatasvir with or without ribavirin; F4: Fibrosis stage 4; HCC: Hepatocellular carcinoma; OLTx: Orthotopic liver transplantation.
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Table 5 Safety of direct-acting antiviral therapy in the steatotic liver disease and non-steatotic liver disease groups, n (%)
ParameterSLD (n = 290)Non-SLD (n = 398)P value
Treatment course0.0784
According to schedule279 (96.2)394 (99)
Therapy modification2 (0.7)1 (0.2)
Therapy discontinuation8 (2.8)3 (0.8)
No data1 (0.3)0
Serious adverse events20 (6.9)10 (2.5)0.0054
Liver-related9 (45)12 (20)20.2465
Non-liver-related11 (55)8 (80)0.2465
AEs leading to treatment discontinuation7 (2.4)3 (0.8)0.1049
Patients with at least one AE46 (15.9)33 (8.3)0.0021
Weakness/fatigue16 (5.5)12 (3)0.1010
Anemia1 (0.3)3 (0.7)0.6423
Headache4 (1.4)1 (0.2)0.1670
AEs of particular interest
Ascites10 (3.4)1 (0.3)0.0011
Hepatic encephalopathy10 (3.4)3 (0.8)0.0194
Gastrointestinal bleeding00NA
Death11 (3.8)4 (1.0)0.0168
Liver-related5 (81.8)32 (50)4> 0.9999
Non-liver-related6 (18.2)2 (50)> 0.9999
1Five cases of liver decompensation, one case of drug-induced liver injury after bosentan, one case of liver transplantation during direct-acting antiviral therapy, two cases of hepatocellular carcinoma diagnosed simultaneously with hepatitis C virus infection.
2One case of liver decompensation, one case of hepatocellular carcinoma diagnosed simultaneously with hepatitis C virus infection.
3Three cases of liver decompensation, two cases of hepatocellular carcinoma.
4One case of liver decompensation, one case of hepatocellular carcinoma.
SLD: Steatotic liver disease; AE: Adverse event.
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Table 6 Comparison of responders and virologic non-responders, univariate analysis, median (Q1-Q3)/n (%)
Parameter
Responders (n = 656)
Non-responders (n = 13)
P value
Gender, women/men339 (51.7)/317 (48.3)1 (7.7) /12 (92.3)0.0014
Age (years)47 (36-63)45 (42-52)0.5863
Age ≥ 50304 (46.3)5 (38.5)0.7802
BMI (kg/m2)25.3 (22.7-28.4)27.8 (25.1-32.4)0.0250
ALT (IU/L)55 (36-91)77 (69-111)0.0544
Albumin (g/dL)4.1 (3.8-4.4)3.3 (2.5-4)0.0078
Bilirubin (mg/dL)0.7 (0.5-0.9)1.5 (1-2.3)0.0000
Haemoglobin14.4 (13.4-15.5)14.4 (12.6-15.1)0.3643
Platelets (× 1000/μL)192 (145-234)79 (74-158)0.0001
Creatinine (mg/dL)0.8 (0.7-0.9)0.9 (0.8-1)0.4954
INR1.0 (1-1.1)1.2 (1.1-1.4)0.0001
HCV RNA (× 106 IU/mL)1 (0.3-2.6)0.6 (0.4-2.9)0.7697
Current treatment regimen
SOF/VEL ± RBV287 (43.7)9 (69.2)0.0900
GLE/PIB364 (55.5)4 (30.8)0.0937
SOF/VEL/VOX5 (0.8)0> 0.9999
Comorbidities
Any504 (76.8)10 (76.9)> 0.9999
Hypertension231 (35.2)2 (15.4)0.2376
Diabetes mellitus66 (10.1)2 (15.4)0.6324
Obesity112 (17.1)4 (30.8)0.2559
Autoimmune disorders41 (6.3)0> 0.9999
Renal disease56 (8.5)1 (7.7)> 0.9999
Non-HCC tumors42 (6.4)1 (7.7)0.5818
Concomitant medications401 (61.1)11 (84.6)0.0847
GT3105 (16.0)7 (53.8)0.0022
History of previous therapy0.0111
Treatment-naïve611 (93.1)9 (69.2)
Treatment-experienced45 (6.9)4 (30.8)
History of hepatic decompensation
Encephalopathy and/or ascites19 (2.9)5 (38.5)< 0.0001
Ascites17 (2.6)5 (38.5)< 0.0001
Encephalopathy3 (0.5)1 (7.7)0.0756
Documented esophageal varices41 (6.3)7 (53.8)< 0.0001
Hepatic decompensation at baseline
Encephalopathy and/or ascites18 (2.7)5 (38.5)< 0.0001
Encephalopathy7 (1.1)1 (7.7)0.1460
Ascites17 (2.6)4 (30.8)0.0004
METAVIR F4128 (19.5)9 (69.2)0.0002
CP B/C, in relation to F426 (20.3)6 (46.2)0.0026
HIV1 (0.2)0> 0.9999
HBV (HBsAg+)3 (0.5)0> 0.9999
HCC8 (1.2)1 (7.7)0.1628
OLTx00NA
Q: Quartile; BMI: Body mass index; ALT: Alanine aminotransferase; INR: International normalized ratio; HCV: Hepatitis C virus; SOF/VEL ± RBV: Sofosbuvir/velpatasvir with or without ribavirin; GLE/PIB: Glecaprevir/pibrentasvir; SOF/VEL/VOX: Sofosbuvir/velpatasvir/voxilaprevir; HCC: Hepatocellular carcinoma; GT3: Genotype 3; F4: Fibrosis stage 4; CP B/C: Child-Pugh Class B or C; HIV: Human immunodeficiency virus; HBV: Hepatitis B virus; HBsAg: Hepatitis B surface antigen; OLTx: Orthotopic liver transplantation.
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Table 7 Factors associated with treatment failure in multivariate analysis
Effect
Effect measure
OR
95%CI
P value
Intercept0.001< 0.001-0.007< 0.0001
GenderMale6.9620.851-56.9380.0704
GT3 infectionYes3.9861.206-13.1820.0234
History of previous therapyExperienced3.0540.764-12.2060.1142
Fibrosis46.7161.80-25.0620.0046
BMI≥ 30 kg/m20.6840.168-2.7870.5958
SLDYes2.5050.488-12.8590.2712
OR: Odds ratio; CI: Confidence interval; GT: Genotype; BMI: Body mass index; SLD: Steatotic liver disease.
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