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Hi Price,
As you say, steatosis (fatty liver) is more prevalent in G3s. It certainly should be considered by anyone with this genotype.
My specialist told me a couple of years ago that it isn’t apparent in my case and my liver seems to be within normal range. On the other hand I do tend toward high serum triglycerides and we don’t really know what I’d be like in the absence of HCV. A good reminder to check current status with him next appt.
Splitdog,
It’s a little more complicated than just being overweight. Steatosis is retention of fat inside the liver cells, being overweight certainly doesn’t help but it can occur even in skinny people. It’s mostly about how your metabolism works. Along the lines of what you eat and how you process it rather than how much you eat.
I believe a good diet, plenty of excercise and aiming for a healthy weight will all help. I won’t suggest diets as there are others more qualified but think lean, mean and lots of energy rather than skinny, starving and weak.
(Lean and mean is a bit of an ask for me these days but I try
)Edit: note to self – must type faster. Thanks LG.
G3a since ’78 – Dx ’12 – F4 (2xHCC)
24wk Tx – PEG/Riba/Dac 2013 relapsed
24wk Tx – Generic Sof/Dac/Riba 2015/16 relapsed
16wk Tx – 12/01/17 -> 03/05/17 NS3/NS5a + Generic Sof
SVR7 – 22/06/17 UND
SRV12 – 27/07/17 UND
SVR24 – 26/10/17 UND
Hi Split,
Sorry to hear your diagnosis. To clarify my previous statement, I was trying to say that weight while relevant isn’t the defining point with NASH in case someone read this thread and thought “oh, I’m not overweight….can’t happen to me”. Losing excess weight will certainly help but it is also about improving your metabolism so there is less tendency for fat to accumulate in your liver. See my comments about a good diet and plenty of exercise.
Many G3s do have NASH at some level (I was careful to qualify comments about myself with the words ‘apparent’ and ‘seems’
but the majority do clear HCV with DAAs, just not quite as many as other genotypes. Here is some further reading on fatty liver and HCV: http://hepatitiscnewdrugresearch.com/fatty-liver-and-hcv.html
Good luck with the diet and excercise, neither of which are really at the top of my list of “things I’d rather be doing”
and best wishes for the next round of treatment on which I suspect we may be fellow travellers.
G3a since ’78 – Dx ’12 – F4 (2xHCC)
24wk Tx – PEG/Riba/Dac 2013 relapsed
24wk Tx – Generic Sof/Dac/Riba 2015/16 relapsed
16wk Tx – 12/01/17 -> 03/05/17 NS3/NS5a + Generic Sof
SVR7 – 22/06/17 UND
SRV12 – 27/07/17 UND
SVR24 – 26/10/17 UND
Gaj wrote:
Good luck with the diet and excercise, neither of which are really at the top of my list of “things I’d rather be doing”
Hi Gaj
Diet & exercise is way down towards the bottom of the list of things that I’d rather be doing, however, I was advised that it should be my main priority during treatment. As it turns out, I’m thankful that I followed this advice because of the health benefits I am now enjoying.
Hopefully I will achieve SVR24 and after that I will revert to living a normal life, enjoying and savouring all of its fruits on offer, but in the interim will continue living with my list of things that I’d rather be doing being inverted on it’s head. It’s only for a few months, and 6 months in total, so not long in the scheme of things considering the many future years that I plan to enjoy life at its fullest.
Maybe you should, with all respects, re-think your priorities.
I’m a former amateur boxer in my youth and rationalised my training before, during, and after treatment as being as fit as possible for my fight with HCV. Its down for the count and it didn’t lay a glove on me.
Respectfully
GT2
1983: Hospitalised with Acute non-A, non-B Hepatitis after ICU blood transfusion 3mths earlier => HCV GT2
22/02/16: (pre-tmt) ALT 61, VL 2.48 IU/ml Hepascore 0.32 (F1/2), fatigue, brain fog, bloating (Treatment Naïve)
10/04/16: (Start tmt) Sofovir +DaclaHep (SOF + DCV) by Hetero Labs in India
09/05/16: ALT 34, VL: NOT Detected 🙂 , FBG 11.9 
17/6/16 FBG 5.7; PPBG (@14.22) 6.9 (@ 20.45) 7.1; BP 124/72
🙂 (Accu-Chek Mobile & Omron Auto BP Monitor) 🙂Oops, sorry! It appears that my attempt at self depreciating humour was misinterpreted.
I fully agree and support the importance of good diet and exercise during treatment to the extent that I have been able to adjust my favourite belt in by several holes and bought half a new wardrobe since commencing treatment. In recognition of the impact on my health and lifestyle I fully intend to continue the process into the future including after achieving SVR.
I have always eaten reasonably well in the past but often too much and while I quite enjoy exercise in the right situation I can be a lazy bastard if I allow myself and/or the weather is inclement (or too nice) thus the aside about “rather be doing”.
(NOT) Gaj’s approved training program.
G3a since ’78 – Dx ’12 – F4 (2xHCC)
24wk Tx – PEG/Riba/Dac 2013 relapsed
24wk Tx – Generic Sof/Dac/Riba 2015/16 relapsed
16wk Tx – 12/01/17 -> 03/05/17 NS3/NS5a + Generic Sof
SVR7 – 22/06/17 UND
SRV12 – 27/07/17 UND
SVR24 – 26/10/17 UND
Hi Gaj
Thanks for clarifying that … it’s just another exercise in pragmatic competence, which was touched upon with the discussion of semantics on another thread.
For those of us who have suffered serious head injuries, pragmatics can be an issue.
I too have needed to adjust my belt by several holes and will now have to buy some new jeans as they are hanging off me.
I’m innately lazy, it’s the default human condition for most I think, but I always get the job done by any means that are needed … like swimming over here at the moment during winter in an outdoor heated pool while it is raining … it’s better than it sounds, as it’s warmer in the pool than out, and you virtually have the pool to yourself.
1983: Hospitalised with Acute non-A, non-B Hepatitis after ICU blood transfusion 3mths earlier => HCV GT2
22/02/16: (pre-tmt) ALT 61, VL 2.48 IU/ml Hepascore 0.32 (F1/2), fatigue, brain fog, bloating (Treatment Naïve)
10/04/16: (Start tmt) Sofovir +DaclaHep (SOF + DCV) by Hetero Labs in India
09/05/16: ALT 34, VL: NOT Detected 🙂 , FBG 11.9
17/6/16 FBG 5.7; PPBG (@14.22) 6.9 (@ 20.45) 7.1; BP 124/72
🙂 (Accu-Chek Mobile & Omron Auto BP Monitor) 🙂Damn Gaj,
Sorry to hear about that shitty news! Yeah GT’3s are the hardest to tx and out of all the genotypes, G3’s seem to relapse more than the any other GT. Good luck Gaj, I’m sure you will get a final SVR, it will just take a little longer.
Gaj,
“For people with genotype 3 though, the link between steatosis and the virus has now been definitively established. Up to 80% of people with genotype 3 have moderate to severe steatosis. It seems that that there is a complex interaction between the core protein of the genotype 3 strand of the virus and liver cells that leads to steatosis. This interaction is not seen in other genotypes. It also seems that the severity of steatosis in these patients is directly related to their viral load. The higher the viral load the greater the amount of steatosis.”Plus, the steatosis is around the portal areas, rather than in the middle of the lobules of the liver like the usual steatosis.
http://hepatitiscnewdrugresearch.com/fatty-liver-and-hcv.html
Reducing dietary saturated fat is associated with an increase in LDL-receptor abundance (which helps the virus multiply) of magnitude similar to the decrease in serum LDL-cholesterol (which is what happens with geno 3).
So it looks like your new diet will have to include restriction of PUFAs in favor of big fat steaks, and eggs and bacon for breakfast instead of cereal, butter, coconut oil
ick:' /> ….and treat during winter when chol is higher (because of seasonal variations in bile acids). 
P
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