[Influence of weight reduction on the effectiveness of combined peginterferon and ribavirin treatment in chronic HCV hepatitis].
Overweight/obesity is an independent negative predictive factor of steatosis in chronic hepatitis C virus infection. The nonresponse to combined peginterferon and ribavirin treatment in infection caused by genotype 1 is associated with the waist circumference, body mass index (BMI), diabetes, steatosis, and degree of fibrosis. The obesity is an independent negative predictive factor of inefficacy of antiviral treatment.


METHODS
The authors summarize the case of a 59-year-old obese (BMI = 46.47 kg/m 2 ) male patient with chronic HCV infection. The weight reduction--after two ineffective antiviral treatments--helped the biochemical and virological response to combined peginterferon-alpha-2a and ribavirin treatment. Between the combined peginterferon and ribavirin therapy, the patient was treated with amantadine and silymarin.


CONCLUSIONS
The authors summarize the importance of steatosis and insulin resistance in chronic HCV hepatitis as well as review the impact of weight reduction and the improvement of insulin sensitivity.


CONCLUSIONS
Body-weight reduction and hepatoprotective drugs might have increased the effectiveness of combined peginterferon and ribavirin treatment and thus the sustained virological response.
Hagymási
Krisztina
K
Semmelweis Egyetem, Altalános Orvostudományi Kar, II. Belgyógyászati Klinika, Budapest, Szentkirályi u. 46. 1088. hkriszti@bel2.sote.hu
Fehér
János
J
D000547:Amantadine / Q000627:therapeutic use*; D000975:Antioxidants / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005234:Fatty Liver / Q000209:etiology / Q000378:metabolism; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007333:Insulin Resistance; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000378:metabolism; D011092:Polyethylene Glycols; D020011:Protective Agents / Q000627:therapeutic use*; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use*; D012838:Silymarin / Q000627:therapeutic use*; D016896:Treatment Outcome; D015431:Weight Loss
D000975:Antioxidants; D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D020011:Protective Agents; D011994:Recombinant Proteins; D012838:Silymarin; D011092:Polyethylene Glycols; D012254:Ribavirin; D000547:Amantadine; C417083:peginterferon alfa-2b