title: Retrospective study of the associations between hepatitis C virus infection and metabolic factors.
abstract: OBJECTIVE
  To evaluate the bidirectional association between metabolic syndrome (MS) components and antiviral treatment response for chronic hepatitis C virus (HCV) infection.
  
  
  METHODS
  This retrospective cohort study included 119 HCV + patients treated with pegylated-interferon-α and ribavirin. Metabolic characteristics and laboratory data were collected from medical records. Differences in baseline clinical and demographic risk factors between responders and non-responders were assessed using independent samplest-tests orχ2tests. The effects of sustained viral response (SVR) to antiviral treatment onde novoimpairments in MS components, including impaired fasting glucose (IFG) and type 2 diabetes mellitus (T2DM), were assessed using univariable and multivariable logistic regression analysis, while the effect of MS components on SVR was assessed using univariable logistic regression analysis.
  
  
  RESULTS
  Of the 119 patients, 80 (67%) developed SVR over the average 54 ± 13 mo follow-up. The cumulative risks forde novoT2DM and IFG were 5.07- (95%CI: 1.261-20.4,P= 0.022) and 3.87-fold higher (95%CI: 1.484-10.15,P= 0.006), respectively for non-responders than responders, when adjusted for the baseline risk factors age, sex, HCV genotype, high viral load, and steatosis. Post-treatment triglyceride levels were significantly lower in non-responders than in responders (OR = 0.27; 95%CI: 0.069-0.962,P= 0.044). Age and HCV genotype 3 were significantly different between responders and non-responders, and MS components were not significantly associated with SVR. Steatosis tended to attenuate SVR (OR = 0.596; 95%CI: 0.331-1.073,P= 0.08).
  
  
  CONCLUSIONS
  SVR was associated with lowerde novoT2DM and IFG incidence and higher triglyceride levels. Patients infected with HCV should undergo T2DM screening and antidiabetic treatment.
authors.affiliation: Shira Yair-Sabag, Elchanan Nussinson, Fahmi Shibli, Azmi Shahbari, Gastroenterology Institute, Emek Medical Center, Afula 18742, Israel.
authors.forename: Shira
authors.initials: S
authors.lastname: Yair-Sabag
authors.affiliation: Shira Yair-Sabag, Elchanan Nussinson, Fahmi Shibli, Azmi Shahbari, Gastroenterology Institute, Emek Medical Center, Afula 18742, Israel.
authors.forename: Elchanan
authors.initials: E
authors.lastname: Nussinson
authors.affiliation: Shira Yair-Sabag, Elchanan Nussinson, Fahmi Shibli, Azmi Shahbari, Gastroenterology Institute, Emek Medical Center, Afula 18742, Israel.
authors.forename: Ofir
authors.initials: O
authors.lastname: Ben-Assuli
authors.affiliation: Shira Yair-Sabag, Elchanan Nussinson, Fahmi Shibli, Azmi Shahbari, Gastroenterology Institute, Emek Medical Center, Afula 18742, Israel.
authors.forename: Fahmi
authors.initials: F
authors.lastname: Shibli
authors.affiliation: Shira Yair-Sabag, Elchanan Nussinson, Fahmi Shibli, Azmi Shahbari, Gastroenterology Institute, Emek Medical Center, Afula 18742, Israel.
authors.forename: Azmi
authors.initials: A
authors.lastname: Shahbari
authors.affiliation: Shira Yair-Sabag, Elchanan Nussinson, Fahmi Shibli, Azmi Shahbari, Gastroenterology Institute, Emek Medical Center, Afula 18742, Israel.
authors.forename: Shira
authors.initials: S
authors.lastname: Zelber-Sagi
keywords: Antiviral therapy; Direct acting antiviral agents; Hepatic steatosis; Hepatitis C virus; Metabolic syndrome; Peg interferon alpha; Ribavirin; Sustained viral response; Type 2 diabetes mellitus