Experience of Using Metformin in Patients Infected with HCV Genotype 3 with Concomitant Metabolic Disorders

Abstract

The so-called "metabolic syndrome" is among the most significant factors that influence the natural course of Chronic Hepatitis C (CHC) and the effectiveness of specific Antiviral Therapy (AVT). Materials and methods: 34 patients with chronic hepatitis C (genotype 3) treated with standard AVT (PEGylated interferon in combination with ribavirin) were included in the study. The study group included 18 patients with chronic hepatitis C in combination with metabolic disorders, namely the Insulin Resistance (IR). They received metformin 20 mg/kg for 24 weeks. The control group included 16 patients with chronic hepatitis C and IR, who did not receive metformin. The patients' age (35.7 ± 1.5) and sex prevalence were matched in both groups. The diagnosis criteria of CHC included: clinical and laboratory signs of the disease, the presence of RNA HCV determined by PCR, with a specific genotype 3. The presence of IR was assessed by HOMA-index (HOMA-IR), fasting insulin levels (IU/ml) × fasting glucose (mmol/L)/22.5. IR was diagnosed in case of HOMA index>2. Conclusion: IR frequently follows the course of CHC in patients with or without metabolic syndrome. Metformin administration leads to weight loss in overweight patients with chronic hepatitis C, reduces the severity of metabolic disorders, such as IR, in these patients, resulting in increased frequency of achieving rapid and early virological responce and biochemical remission. The administration of metformin had a positive effect on liver steatosis, resulting in a decrease of its severity according to ultrasonography.