Insulin resistance is a major determinant of sustained virological response in genotype 1 chronic hepatitis C patients receiving peginterferon α‐2b plus ribavirin

Chu, Chi‐Jen; Lee, S.-D.; Hung, Tsung–Hsing; Lin, Han Chieh; Hwang, Shinn Jang; Lee, F.-Y.; Lu, Ruey-Hwa; Yu, Ming‐Lung; Chang, Ching S.; Yang, Penghui; Lee, C.-Y.; Chang, Full‐Young

doi:10.1111/j.1365-2036.2008.03823.x

Cited by 52 publications

(47 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Insulin resistance has been clearly associated with steatosis, more severe and progressive fibrosis, and a reduced response to PEG-IFN and RBV therapy in HCV patients [13] . Several recent studies have confirmed that SVR is impaired in patients with a high homoeostasis model assessment index [14] . Obesity/Hepatic steatosis: In hepatitis C infection, hepatic steatosis might be either metabolic [overweight & obesity (BMI ≥ 25), diabetes mellitus] or cytopathic due to the effect of the virus, as in genotype 3.…”

Section: Insulin Resistancementioning

confidence: 99%

Hepatitis C comorbidities affecting the course and response to therapy

El-Zayadi¹

2009

WJG

View full text Add to dashboard Cite

Several studies have demonstrated that the outcome of chronic hepatitis C (CHC) infection is profoundly influenced by a variety of comorbidities. Many of these comorbidities have a significant influence on the response to antiviral therapy. These comorbidities negatively affect the course and outcome of liver disease, often reducing the chance of achieving a sustained virological response with PEGylated interferon and ribavirin treatments. Comorbidities affecting response to antiviral therapy reduce compliance and adherence to inadequate doses of therapy. The most important comorbidities affecting the course of CHC include hepatitis B virus coinfection, metabolic syndrome, and intestinal bacterial overgrowth. Comorbidities affecting the course and response to therapy include schistosomiasis, iron overload, alcohol abuse, and excessive smoking. Comorbidities affecting response to antiviral therapy include depression, anemia, cardiovascular disease, and renal failure.

show abstract

Section: Insulin Resistancementioning

confidence: 99%

Hepatitis C comorbidities affecting the course and response to therapy

El-Zayadi¹

2009

WJG

View full text Add to dashboard Cite

show abstract

“…Besides having higher rates of progression to liver fibrosis, patients with chronic HCV hepatitis and IR are less likely to respond to antiviral therapy (9,(18)(19)(20). In Brazil, no studies have determined the rate of IR occurrence in chronically HCV-infected populations, or the consequence of such association.…”

Section: Introductionmentioning

confidence: 99%

Insulin resistance in non-diabetic patients with chronic hepatitis C: what does it mean?

Souza

Pace²,

Chebli³

et al. 2011

Arq Bras Endocrinol Metab

View full text Add to dashboard Cite

Objectives: To determine the prevalence of insulin resistance (IR) in non-diabetic patients with chronic hepatitis C, and to assess the association between IR, laboratory parameters and histological findings. Subjects and methods: Eighty-two patients had their serum analyzed for glucose, lipid profile, C-reactive protein (CRP), ferritin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), HOMA-IR, viral load and HCV genotype. Patients with HOMA-IR levels > 2.5 were considered as carriers of insulin resistance. Results: IR was observed in 27% of patients and was associated with age, waist circumference and body mass index. IR patients were more likely to have more advanced hepatic fibrosis and necroinflammatory activity, higher levels of aminotransferases and liver steatosis than patients without IR. Conclusions: Insulin resistance is often present in patients with chronic hepatitis C, and this parameter is associated with more advanced HCV-related hepatic fibrosis. Arq Bras Endocrinol Metab. 2011;55(6):412-8 Keywords Chronic hepatitis C; liver fibrosis; insulin resistance; HOMA-IR RESUMO Objetivos: Em portadores de hepatite crônica C não diabéticos, verificar a prevalência de resistência insulínica (RI) e analisar a associação desta com os parâmetros laboratoriais e histológicos. Sujeitos e métodos: Foram incluídos no estudo 82 pacientes, e amostras de sangue foram coletadas para determinação de glicose, perfil lipídico, alanina aminotransferase (ALT), aspartato aminotransferase (AST), ferritina, HOMA-IR, carga viral e genótipo do VHC. HOMA--IR superior a 2,5 foi considerado resistência insulínica. Resultados: RI foi observada em 27% dos pacientes e foi associada a idade, circunferência abdominal e índice de massa corpórea. Quando comparado a pacientes sem RI, aqueles com HOMA-IR superior a 2,5 apresentaram graus mais acentuados de fibrose hepática e atividade necroinflamatória, maiores níveis de aminotransferases e esteatose hepática mais frequente. Conclusões: É comum a presença de RI em portadores de hepatite crônica C e esta se associa com graus mais avançados de fibrose hepática induzida pelo vírus da hepatite C. Arq Bras Endocrinol Metab. 2011;55(6):412-8 Descritores

show abstract

“…In the presence of steatosis, apoptosis is correlated with activation of stellate cells and increased stage of fibrosis, in keeping with the hypothesis that a steatotic liver is more vulnerable to liver injury, and suggesting another mechanism of liver disease progression in patients with fatty liver and the metabolic syndrome [109] . Increasing levels of IR are associated with reduced rates of initial virological response [111][112][113] as well as SVR in chronic hepatitis C patients treated with a combination of pegylated IFN-a and ribavirin [114][115][116][117][118][119] . This negative association has been reported not only in patients infected with the HCV genotype 1 [114,116,119] , but also in those with the so-called "easy-to-treat" genotypes 2 and 3 [118] .…”

Section: Clinical Consequences Of Ir/t2d In Chronic Hepatitis Cmentioning

confidence: 99%

Hepatitis C virus and type 2 diabetes

Negro¹,

Alaei²

2009

WJG

140

116

View full text Add to dashboard Cite

This review focuses on the relationship between h e p a t i t i s C v i r u s ( H C V ) i n fe c t i o n a n d g l u c o s e metabolism derangements. Cross-sectional and longitudinal studies have shown that the chronic HCV infection is associated with an increased risk of developing insulin resistance (IR) and type 2 diabetes (T2D). The direct effect of HCV on the insulin signaling has been analyzed in experimental models. Although currently available data should be considered as preliminary, HCV seems to affect glucose metabolism via mechanisms that involve cellular pathways that have been implicated in the host innate immune response. IR and T2D not only accelerate the histological and clinical progression of chronic hepatitis C, but also reduce the early and sustained virological response to interferonalpha-based therapy. Thus, a detailed knowledge of the mechanisms underlying the HCV-associated glucose metabolism derangements is warranted, in order to improve the clinical management of chronic hepatitis C patients.

show abstract

Insulin resistance is a major determinant of sustained virological response in genotype 1 chronic hepatitis C patients receiving peginterferon α‐2b plus ribavirin

Abstract: SUMMARY BackgroundCross-sectional studies suggest insulin resistance is strongly associated with hepatic steatosis and fibrosis in patients with chronic hepatitis C (CHC), which might affect the efficacy of antiviral therapy.

Cited by 52 publications

References 54 publications

Hepatitis C comorbidities affecting the course and response to therapy

Hepatitis C comorbidities affecting the course and response to therapy

Insulin resistance in non-diabetic patients with chronic hepatitis C: what does it mean?

Hepatitis C virus and type 2 diabetes

Contact Info

Product

Resources

About