title: Insulin Resistance Predicts Virological Response to Interferon-α in Chronic Hepatitis B Patients.
abstract: To elucidate impact of insulin resistance (IR) on the response to interferon-α (IFN-α) therapy in chronic hepatitis B (CHB) patients.
  
  
  
  Metabolic factors influencing the virological response of CHB patients on IFN-α treatment are still unexplored.
  
  
  
  Eighty CHB patients were treated with IFN-α for 48 weeks. The IR was evaluated by homeostasis model assessment of IR (HOMA-IR) before treatment. Viral load and biochemical parameters were measured at 12, 24, and 48 weeks after starting treatment, and then 24 weeks after the end of treatment. IFN-γ and tumor necrosis factor-α were tested at baseline and 12 weeks of treatment.
  
  
  
  Pretreatment HOMA-IR proved to be the only independent predictor of primary nonresponse, as well as the pretreatment HOMA-IR, viral load and primary nonresponse were independently associated with virological response at 24, 48 weeks of treatment and at the follow-up endpoint. The significant higher virological relapse rate in patients with IR was observed in patients with virological response at 48 weeks of treatment. The mean HOMA-IR was significantly lower in virological responders than in virological nonresponders. The secretion of IFN-γ and tumor necrosis factor-α was not induced in patients with IR at 12 weeks after IFN-α treatment.
  
  
  
  Our data suggest that IR is strongly associated with virological response, thus reflecting the important role played by metabolic factors in the viral kinetics during IFN-α treatment. These findings suggested clinical application of pretreatment HOMA-IR could enable treatment outcome to be predicted and treatment regimens to be determined.
authors.affiliation: *Department of Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an †Center for Clinical Laboratory ‡Department of Liver Diseases, the Eighth Hospital of Xi'an, Shaanxi Province, P. R. China.
authors.forename: Xin
authors.initials: X
authors.lastname: Wang
authors.forename: Ying-Ren
authors.initials: YR
authors.lastname: Zhao
authors.forename: Hong-Li
authors.initials: HL
authors.lastname: Liu
authors.forename: Xiao-Hua
authors.initials: XH
authors.lastname: Ma
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhang
authors.forename: Rui-Tian
authors.initials: RT
authors.lastname: Yi
mesh_terms: D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D007333:Insulin Resistance; D016898:Interferon-alpha / Q000627:therapeutic use*; D007371:Interferon-gamma / Q000378:metabolism; D008297:Male; D013997:Time Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D019562:Viral Load; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma