title: Pilot study of pioglitazone before HCV retreatment in HIV/HCV genotype 1-infected subjects with insulin resistance and previous nonresponse to peginterferon and ribavirin therapy: A5239.
abstract: : Insulin resistance is associated with nonresponse to hepatitis C virus (HCV) treatment. In this multicenter, single-arm pilot study, adult, HIV/HCV genotype 1-coinfected previous nonresponders to peginterferon/ribavirin (PegIFN/RBV) with homeostatic model assessment of insulin resistance >2.5 were treated with pioglitazone (PIO) for 24 weeks followed by PegIFN/RBV/PIO. Three of 19 subjects (15.8%) achieved undetectable HCV RNA at week 24 of PegIFN/RBV/PIO, which was not significantly different than the historical null rate of 10% (P = 0.29, lower limit of the exact 1-sided 90% confidence interval 5.9%). Over the 24 weeks of PIO monotherapy, alanine aminotransferase and aspartate aminotransferase declined significantly and correlated with improved metabolic parameters.
authors: *Division of Infectious Diseases, Weill Cornell Medical College, New York, NY; †Harvard School of Public Health, Boston, MA; ‡Gastrointestinal Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA; §National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; ‖Division of Infectious Diseases, University of California San Francisco Medical School, San Francisco, CA; ¶Medical Service, Department of Veterans Affairs, San Francisco, CA; and #HIV/AIDS Division, San Francisco General Hospital, University of California, San Francisco, CA.
authors: Kristen M
authors: KM
authors: Marks
authors: Douglas
authors: D
authors: Kitch
authors: Raymond T
authors: RT
authors: Chung
authors: Colleen
authors: C
authors: Hadigan
authors: Janet
authors: J
authors: Andersen
authors: Phyllis
authors: P
authors: Tien
authors: Annie
authors: A
authors: Luetkemeyer
authors: Beverly
authors: B
authors: Alston-Smith
authors: Marshall J
authors: MJ
authors: Glesby
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D001219:Aspartate Aminotransferases / Q000097:blood; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000150:complications*; D016174:Hepacivirus / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007333:Insulin Resistance; D008297:Male; D010865:Pilot Projects; D000077205:Pioglitazone; D012367:RNA, Viral / Q000097:blood; D019233:Retreatment; D012254:Ribavirin / Q000627:therapeutic use; D045162:Thiazolidinediones / Q000008:administration & dosage*; D017211:Treatment Failure; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D007004:Hypoglycemic Agents; D012367:RNA, Viral; D045162:Thiazolidinediones; D012254:Ribavirin; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000077205:Pioglitazone