title: Glucose abnormalities are an independent risk factor for nonresponse to antiviral treatment in chronic hepatitis C.
abstract: OBJECTIVE
  The influence of glucose abnormalities on the efficacy of antiviral treatment is unknown. This study investigated whether glucose abnormalities (impaired fasting glucose and type 2 diabetes) influence the response to antiviral therapy with interferon plus ribavirin in patients with chronic hepatitis C.
  
  
  METHODS
  A total of 178 treatment-naïve patients with chronic hepatitis C treated with combination therapy were retrospectively studied. SVR was assessed after completing treatment. Fasting plasmatic glucose was measured prior to therapy.
  
  
  RESULTS
  Compared with nonresponders (N = 111), patients with SVR (N = 67) had lower plasma glucose (94.1 +/- 12.7 vs 104.4 +/- 25.8 mg/dL, P= 0.001) and a lower prevalence of glucose abnormalities (24.24%vs 44.14%, P= 0.012). The SVR rate was 45.13% in patients with normoglycemia (N = 113), 28.26% in patients with impaired fasting glucose (N = 46), and 15.78% in type 2 diabetic patients (N = 19) (P < 0.001). Multivariate logistic regression identified genotype 1 (OR 1.55, 95% CI 1.01-2.41, P= 0.05), gamma-glutamyltranspeptidase level (OR 6.41, 95% CI 1.86-22.07, P= 0.003), and presence of glucose abnormalities (OR 2.33, 95% CI 1.04-5.20, P= 0.039) as being independently associated with the absence of an SVR. In addition, patients with glucose abnormalities (N = 65) showed a lower virological response rate when compared with a subgroup of normoglycemic patients (N = 65) matched for sex, age, and liver fibrosis (24.6%vs 44.6%, P= 0.001).
  
  
  CONCLUSIONS
  Glucose abnormalities are an independent predictor of poor virological response to combined therapy in hepatitis C virus infected patients.
authors.affiliation: Diabetes Research Unit, Endocrinology Division, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Albert
authors.initials: A
authors.lastname: Lecube
authors.forename: Cristina
authors.initials: C
authors.lastname: Hernández
authors.forename: Rafael
authors.initials: R
authors.lastname: Simó
authors.forename: Juan Ignacio
authors.initials: JI
authors.lastname: Esteban
authors.forename: Joan
authors.initials: J
authors.lastname: Genescà
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage*; D001786:Blood Glucose / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005215:Fasting / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D017211:Treatment Failure
chemical_list: D000998:Antiviral Agents; D001786:Blood Glucose