OBJECTIVES: Genotype-specific associations between hepatitis C virus (HCV) and insulin resistance (IR) have been described, but a causal relationship remains unclear. This study investigated the association between a sustained virological response (SVR) and IR after chronic HCV therapy. METHODS: 2255 treatment-naive patients with chronic HCV genotype 1 or 2/3 were enrolled in two phase 3 trials of albinterferon alpha-2b versus pegylated interferon alpha-2a for 48 or 24 weeks, respectively. IR was measured before treatment and 12 weeks after treatment using homeostasis model assessment (HOMA)-IR. RESULTS: Paired HOMA-IR measurements were available in 1038 non-diabetic patients (497 with genotype 1; 541 with genotype 2/3). At baseline the prevalence of HOMA-IR >3 was greater in patients with genotype 1 than 2/3 (33% vs 27%; p=0.048). There was a significant reduction in the prevalence of IR in patients with genotype 1 achieving SVR (δ 10%; p<0.001), but not in genotype 1 non-responders or those with genotype 2/3. Multivariate analysis indicated that SVR was associated with a significant reduction in mean HOMA-IR in patients with genotype 1 (p=0.004), but not in those with genotype 2/3, which was independent of body mass index, alanine transaminase, γ-glutamyl transpeptidase and lipid level changes. CONCLUSIONS: SVR is associated with a reduction in HOMA-IR in patients with HCV genotype 1 but not in those with genotype 2/3. Genotype 1 may have a direct effect on the development of IR, independent of host metabolic factors, and may be partially reversed by viral eradication.
OBJECTIVES: Genotype-specific associations between hepatitis C virus (HCV) and insulin resistance (IR) have been described, but a causal relationship remains unclear. This study investigated the association between a sustained virological response (SVR) and IR after chronic HCV therapy. METHODS: 2255 treatment-naive patients with chronic HCV genotype 1 or 2/3 were enrolled in two phase 3 trials of albinterferon alpha-2b versus pegylated interferon alpha-2a for 48 or 24 weeks, respectively. IR was measured before treatment and 12 weeks after treatment using homeostasis model assessment (HOMA)-IR. RESULTS: Paired HOMA-IR measurements were available in 1038 non-diabeticpatients (497 with genotype 1; 541 with genotype 2/3). At baseline the prevalence of HOMA-IR >3 was greater in patients with genotype 1 than 2/3 (33% vs 27%; p=0.048). There was a significant reduction in the prevalence of IR in patients with genotype 1 achieving SVR (δ 10%; p<0.001), but not in genotype 1 non-responders or those with genotype 2/3. Multivariate analysis indicated that SVR was associated with a significant reduction in mean HOMA-IR in patients with genotype 1 (p=0.004), but not in those with genotype 2/3, which was independent of body mass index, alanine transaminase, γ-glutamyl transpeptidase and lipid level changes. CONCLUSIONS: SVR is associated with a reduction in HOMA-IR in patients with HCV genotype 1 but not in those with genotype 2/3. Genotype 1 may have a direct effect on the development of IR, independent of host metabolic factors, and may be partially reversed by viral eradication.
Authors: S Caronia; K Taylor; L Pagliaro; C Carr; U Palazzo; J Petrik; S O'Rahilly; S Shore; B D Tom; G J Alexander Journal: Hepatology Date: 1999-10 Impact factor: 17.425
Authors: Manuel Romero-Gómez; Maria Del Mar Viloria; Raúl J Andrade; Javier Salmerón; Moisés Diago; Conrado M Fernández-Rodríguez; Raquel Corpas; Marina Cruz; Lourdes Grande; Luis Vázquez; Paloma Muñoz-De-Rueda; Pilar López-Serrano; Ana Gila; María L Gutiérrez; Celia Pérez; Angela Ruiz-Extremera; Emilio Suárez; Jesús Castillo Journal: Gastroenterology Date: 2005-03 Impact factor: 22.682
Authors: A L Mason; J Y Lau; N Hoang; K Qian; G J Alexander; L Xu; L Guo; S Jacob; F G Regenstein; R Zimmerman; J E Everhart; C Wasserfall; N K Maclaren; R P Perrillo Journal: Hepatology Date: 1999-02 Impact factor: 17.425