1. Insulin resistance predicts response to peginterferon-alpha/ribavirin combination therapy in chronic hepatitis C patients
- Author
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Dai, Chia-Yen, Huang, Jee-Fu, Hsieh, Ming-Yen, Hou, Nai-Jen, Lin, Zu-Yau, Chen, Shinn-Chern, Hsieh, Ming-Yuh, Wang, Liang-Yen, Chang, Wen-Yu, Chuang, Wan-Long, and Yu, Ming-Lung
- Subjects
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INSULIN resistance , *HEPATITIS C , *ANTIVIRAL agents , *COMBINATION drug therapy , *CHRONIC diseases , *PANCREATIC beta cells , *BODY mass index , *PATIENTS - Abstract
Background/Aims: Insulin resistance (IR) might be associated with hepatitis C virus (HCV) infection. This study aimed to elucidate impact of IR and beta-cell function on the response to peginterferon-alpha (PEG-IFN)/ribavirin combination therapy in chronic hepatitis C (CHC) patients. Methods: Three hundred and thirty patients without overt diabetes were treated with combination therapy with (PEG-IFN)/ribavirin for 24 weeks. The IR and beta-cell function were evaluated by homeostasis model assessment of IR (HOMA-IR) and homeostasis model assessment of beta-cell function (HOMA-beta) before treatment. Results: HCV genotype, pretreatment HCV RNA level and pretreatment HOMA-IR, but not HOMA-beta, were independent factors associated with sustained virologic response (SVR). In 150 patients with genotype 1b infection, pretreatment HCV RNA level, HOMA-IR and age were independent predictors for SVR. The significantly lower SVR rate in high HOMA-IR patients was observed in 76 patients with high HCV RNA levels (⩾400,000IU/mL) who were defined as ‘difficult-to-treat’ patients. The mean HOMA-IR of ‘difficult-to-treat’ patients was significantly lower in 42 sustained responders than in 34 non-responders. Conclusions: IR was associated with SVR to (PEG-IFN)/ribavirin therapy for CHC, especially among ‘difficult-to-treat’ patients. These findings suggested clinical application of pretreatment HOMA-IR could enable treatment outcome to be predicted and treatment regimens to be determined. [Copyright &y& Elsevier]
- Published
- 2009
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