Even after achieving a cure for hepatitis C virus (HCV), individuals may remain at high risk for developing non-alcoholic fatty liver disease (NAFLD, or fatty liver for short).

Investigators compared tests of liver health among 101 people before and after they were cured of hep C. The average age of the participants was 60, and they had an average body mass index, or BMI, of 28 (25 is overweight; 30 is obese). Nine out of 10 had diabetes.

Those in the post–hep C cure group saw a significant drop in their ALT and AST liver enzymes and liver fibrosis (scarring) severity. However, 48 percent showed evidence of steatosis, which is the buildup of fat in the liver and an indicator of fatty liver disease. Six percent of those with such fat buildup and none of those without had advanced fibrosis.

“Our findings do not specifically link NALFD to hepatitis C treatment or being cured of hepatitis C,” says the study’s lead author, Mazen Noureddin, MD, the director of the Cedars-Sinai Fatty Liver Program in Los Angeles. “But patients who have the risk factors for NAFLD–those who are diabetics and/or overweight—should be evaluated for the liver disease once they have completed treatment for hep C.”