title: Clearance of Hepatitis C Virus Improves Insulin Resistance During and After Peginterferon and Ribavirin Therapy.
abstract: Patients with chronic hepatitis C virus (HCV) infection are at a greater risk of developing insulin resistance (IR). However, little is known about when insulin sensitivity may improve during or after treatment for hepatitis C. In this study, we examined the effect of combination therapy with pegylated interferon-α and ribavirin on IR in patients with chronic HCV infection. We also analyzed factors associated with changes in insulin sensitivity. IR was estimated by homeostasis model assessment (HOMA-IR). HOMA-IR was measured before therapy, during therapy (12 and 24 weeks), and at the end of therapy (EOT; 24 or 48 weeks). We analyzed 78 HCV patients receiving combination therapy. Twenty-two patients (28.2%) exhibited pretreatment IR (HOMA-IR >2.5). In all patients, HOMA-IR was not significantly different from baseline values at 12 weeks (P = 0.823), 24 weeks (P = 0.417), or at EOT (P = 0.158). In patients with pretreatment IR, a significant decrease in HOMA-IR was observed at 12 weeks (P = 0.023), 24 weeks (P = 0.008), and at EOT (P = 0.002). Multivariate analysis using a logistic regression model showed that baseline HOMA-IR is the only factor associated with the decline in HOMA-IR during and after therapy. The eradication of HCV infection was associated with improved insulin sensitivity among patients with pretreatment IR. This significant improvement in insulin sensitivity may occur as early as 12 weeks after the initiation of antiviral therapy.
authors: Liver Research Unit, College of Medicine, Chang Gung Memorial Hospital, Chang Gung University , Keelung, Taiwan .
authors: Cheng-Hung
authors: CH
authors: Chien
authors: Liver Research Unit, College of Medicine, Chang Gung Memorial Hospital, Chang Gung University , Keelung, Taiwan .
authors: Chih-Lang
authors: CL
authors: Lin
authors: Liver Research Unit, College of Medicine, Chang Gung Memorial Hospital, Chang Gung University , Keelung, Taiwan .
authors: Ching-Chih
authors: CC
authors: Hu
authors: Liver Research Unit, College of Medicine, Chang Gung Memorial Hospital, Chang Gung University , Keelung, Taiwan .
authors: Jia-Jang
authors: JJ
authors: Chang
authors: Liver Research Unit, College of Medicine, Chang Gung Memorial Hospital, Chang Gung University , Keelung, Taiwan .
authors: Rong-Nan
authors: RN
authors: Chien
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D001835:Body Weight; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology*; D006526:Hepatitis C / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology* / Q000821:virology*; D006801:Humans; D007333:Insulin Resistance; D016898:Interferon-alpha / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D012254:Ribavirin / Q000627:therapeutic use; D012307:Risk Factors; D016896:Treatment Outcome; D019562:Viral Load; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012254:Ribavirin