Insulin resistance (IR) might be associated with hepatitis C virus (HCV) infection. This study aimed to elucidate impact of IR and beta-cell function on the response to peginterferon-alpha (PEG-IFN)/ribavirin combination therapy in chronic hepatitis C (CHC) patients.
Three hundred and thirty patients without overt diabetes were treated with combination therapy with (PEG-IFN)/ribavirin for 24 weeks. The IR and beta-cell function were evaluated by homeostasis model assessment of IR (HOMA-IR) and homeostasis model assessment of beta-cell function (HOMA-beta) before treatment.
HCV genotype, pretreatment HCV RNA level and pretreatment HOMA-IR, but not HOMA-beta, were independent factors associated with sustained virologic response (SVR). In 150 patients with genotype 1b infection, pretreatment HCV RNA level, HOMA-IR and age were independent predictors for SVR. The significantly lower SVR rate in high HOMA-IR patients was observed in 76 patients with high HCV RNA levels (⩾400,000 IU/mL) who were defined as ‘difficult-to-treat’ patients. The mean HOMA-IR of ‘difficult-to-treat’ patients was significantly lower in 42 sustained responders than in 34 non-responders.
IR was associated with SVR to (PEG-IFN)/ribavirin therapy for CHC, especially among ‘difficult-to-treat’ patients. These findings suggested clinical application of pretreatment HOMA-IR could enable treatment outcome to be predicted and treatment regimens to be determined.
Abbreviations:ALT (alanine aminotransferase), anti-HCV (HCV antibody), FPG (fasting plasma glucose), BMI (body mass index), CHC (chronic hepatitis), HBsAg (hepatitis B surface antigen), SVR (sustained virologic response), HOMA (homeostasis model assessment), IR (insulin resistance), DM (diabetes mellitus), HAI (histological activity index)
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Published online: February 06, 2009
Accepted: December 9, 2008
Received in revised form: December 4, 2008
Received: July 27, 2008Associate Editor: F. Negro
☆The authors who have taken part in the research of this paper declared that they do not have a relationship with the manufacturers of the drugs involved either in the past or present and they did not receive funding from the manufacturers to carry out their research.
© 2009 European Association for the Study of the Liver. Published by Elsevier Inc. All rights reserved.