Improvement of glucose and lipid metabolism with pegylated interferon-a plus ribavirin therapy in Chinese patients chronically infected with genotype 1b hepatitis C virus.
BACKGROUND
Many epidemiological studies have demonstrated a significant association between Type 2 diabetes mellitus and abnormal lipid profiles with chronic HCV genotype 1 (GT1) infection. We examined the impact on glucose and lipid profiles of treating Chinese patients using pegylated interferon (Peg-IFN)-a and ribavirin (RBV).


METHODS
We conducted a hospital-based clinical study of Chinese patients chronically infected with GT1b HCV. All the patients were treated for 48 weeks (PR48) with Peg-IFN-a (180 micro g once per week) or Peg-IFN-a (1.5 micro g/kg once per week) plus RBV (15 mg/kg per day). Fasting blood glucose (FBG), postprandial blood glucose (PBG-2h), glycosylated hemoglobin (HbA1c), total cholesterol (TC) and triglyceride (TG) levels, were measured at baseline, during therapy, at the end of therapy and at follow-up. In addition, liver stiffness (LS) by transient elastography, HCV RNA and ALT levels were also measured.


RESULTS
We enrolled 116 patients. At the end of treatment (EOT) (week 48), HCV RNA was negative in all patients, 77.6% (90/116) of patients achieved sustained virologic response (SVR) 24 weeks after EOT, and 22.4% (26/116) did not achieve SVR. All parameters associated with liver inflammation, liver fibrosis, glucose and lipid metabolism had decreased significantly compared with baseline (P < .05) in SVR patients. However, there were no obvious changes in lipid metabolism in non-SVR patients.


CONCLUSIONS
PR48 therapy is still the primary treatment for Chinese patients with GT1b HCV infection and will remain so until oral anti-HCV agents are approved. It is beneficial in amelioration of liver histological status and glucose metabolism regardless of post-treatment virologic response.
Shao
S
Qing
Dong Ji MD, Liver Cirrhosis Diagnosis and Treatment Second Center,, 302 Military Hospital of China,, 100 XiSiHuan Middle Road,, Beijing 100039, China, jidg302@126.com.
Dong
D
Ji
Dong Ji MD, Liver Cirrhosis Diagnosis and Treatment Second Center,, 302 Military Hospital of China,, 100 XiSiHuan Middle Road,, Beijing 100039, China, jidg302@126.com.
Bing
B
Li
Dong Ji MD, Liver Cirrhosis Diagnosis and Treatment Second Center,, 302 Military Hospital of China,, 100 XiSiHuan Middle Road,, Beijing 100039, China, jidg302@126.com.
Fan
F
Li
Yudong
Y
Wang
Xioaxia
X
Niu
Binfang
B
Ling
Yuhua
Y
Meng
George
G
Lau
Guofeng
G
Chen
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000008:administration & dosage*; D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism; D002681:China; D002784:Cholesterol / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000821:virology; D004359:Drug Therapy, Combination; D054459:Elasticity Imaging Techniques; D005215:Fasting / Q000097:blood; D005260:Female; D005838:Genotype; D006442:Glycated Hemoglobin / Q000187:drug effects; D016174:Hepacivirus / Q000187:drug effects / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000097:blood / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage*; D050356:Lipid Metabolism / Q000187:drug effects*; D008099:Liver / Q000000981:diagnostic imaging / Q000187:drug effects / Q000821:virology; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period; D012367:RNA, Viral / Q000097:blood; D012254:Ribavirin / Q000008:administration & dosage*; D014280:Triglycerides / Q000378:metabolism
D000410:Alanine Transaminase; D000998:Antiviral Agents; D001786:Blood Glucose; D002784:Cholesterol; D006442:Glycated Hemoglobin; D016898:Interferon-alpha; D012367:RNA, Viral; D012254:Ribavirin; D014280:Triglycerides; C517652:hemoglobin A1c protein, human