Sustained virological response following chronic hepatitis C treatment is associated with improvement in insulin resistance. Issue 6 (9th June 2013)

• Record Type: Journal Article
• Authors: Chan, C. H. Y.; Hansen, R. D.; Gilliver, R. S.; Jones, B. E.
• Is Part Of: Internal medicine journal. Volume 43:Issue 6(2013)
• Page Start: 656
• Page End: 662
• Publication Date: 2013-06-09
• Subjects: Medicine -- Periodicals; 616
• DOI: 10.1111/imj.12136
• Languages: English
• ISSNs: 1444-0903

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="imj12136-sec-0001" sec-type="section"> <title>Background</title> <p>Insulin resistance (IR) is a key factor in the development of hepatic steatosis and fibrosis in chronic hepatitis C virus infection. Little is known about the impact of viral clearance on IR.</p> </sec> <sec id="imj12136-sec-5001" sec-type="section"> <title>Aim</title> <p>The aim of this study was to determine the impact of viral clearance on IR.</p> </sec> <sec id="imj12136-sec-0002" sec-type="section"> <title>Methods</title> <p>Eighty‐six patients treated according to standard clinical practice at an Australian teaching hospital between 2003 and 2007 were prospectively studied. Demographic, biochemical and histological data were collected.</p> </sec> <sec id="imj12136-sec-0003" sec-type="section"> <title>Results</title> <p>The mean pretreatment homeostatic model assessment–IR (HOMA‐IR) was similar in the sustained virological response (SVR) and non‐SVR groups (2.7 ± 0.5 and 2.8 ± 0.4, respectively), and both values were consistent with significant IR. There was a significant improvement in HOMA‐IR (from 3.0 ± 1.0 to 2.2 ± 0.5, <italic>P</italic> = 0.04) at the end of treatment in the SVR group only. This trended towards significance at 6 months post‐treatment. Multiple regression analysis found improvement in both gamma‐glutamyl transpeptidase and alanine aminotransferase predicted improvement in HOMA‐IR when controlled for other potential factors (<italic>P</italic> = 0.01).</p> </sec> <sec id="imj12136-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Hepatitis C virus clearance is associated with improvement in IR. Although baseline hepatic fibrosis is a predictor of IR, changes in IR appear to be independent of changes in liver fibrosis. Treatment‐related improvement in gamma‐glutamyl transpeptidase and alanine aminotransferase seen with improved IR may be a possible marker of reduction of hepatic oxidative stress.</p> </sec> </abstract>