title: Impact of Body Weight Reduction via Diet and Exercise on the Anti-Viral Effects of Pegylated Interferon Plus Ribavirin in Chronic Hepatitis C Patients with Insulin Resistance: A Randomized Controlled Pilot Trial.
abstract: OBJECTIVE
  Insulin resistance (IR) modifies the anti-viral effects of interferon (IFN) therapy in patients with chronic hepatitis C (CHC). This prospective study evaluated whether lifestyle interventions improve the anti-viral response to treatment with pegylated (PEG)-IFN plus ribavirin (RBV) in patients with CHC.
  
  
  METHODS
  The study cohort consisted of 60 patients chronically infected with a high viral load of hepatitis C virus genotype 1b and a homeostasis model assessment of IR (HOMA-IR) value above 2. The patients were divided into two groups, an intervention group (n=26) and a control group (n=34). The patients in the intervention group were prescribed diet and exercise treatment for 3-6 months to reduce their body weight by ≥5% before starting treatment with PEG-IFN plus RBV.
  
  
  RESULTS
  Diet and exercise significantly reduced the HOMA-IR values in the intervention group, from 3.4 to 2.5 (p=0.0009), especially among the 15 patients who achieved a body weight reduction of ≥5%. The viral disappearance rate at 12 weeks was significantly higher in the intervention group among the patients with a ≥5% weight reduction than in the control group (53.3% vs. 23.5%, p=0.01). However, the sustained viral response (SVR) rates were similar.
  
  
  CONCLUSIONS
  Improvements in IR achieved through weight reduction via lifestyle interventions may enhance the early viral response to PEG-IFN plus RBV in patients with CHC. However, this intervention program has no effect on the SVR rate.
authors.affiliation: Department of Internal Medicine, Saga University Hospital, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Iwane
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Mizuta
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Kawaguchi
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Takahashi
authors.forename: Noriko
authors.initials: N
authors.lastname: Oza
authors.forename: Satoshi
authors.initials: S
authors.lastname: Oeda
authors.forename: Shunya
authors.initials: S
authors.lastname: Nakashita
authors.forename: Takuya
authors.initials: T
authors.lastname: Kuwashiro
authors.forename: Taiga
authors.initials: T
authors.lastname: Otsuka
authors.forename: Seiji
authors.initials: S
authors.lastname: Kawazoe
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Eguchi
authors.forename: Keizo
authors.initials: K
authors.lastname: Anzai
authors.forename: Iwata
authors.initials: I
authors.lastname: Ozaki
authors.forename: Kazuma
authors.initials: K
authors.lastname: Fujimoto
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D001835:Body Weight / Q000187:drug effects*; D004032:Diet; D037001:Directive Counseling; D004359:Drug Therapy, Combination; D015444:Exercise; D005260:Female; D019698:Hepatitis C, Chronic / Q000097:blood / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007333:Insulin Resistance; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000517:prevention & control*; D010865:Pilot Projects; D011446:Prospective Studies; D012254:Ribavirin / Q000627:therapeutic use*; D016896:Treatment Outcome; D019562:Viral Load / Q000235:genetics; D015431:Weight Loss / Q000187:drug effects*
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012254:Ribavirin