Insulin Resistance and Diabetes Contribute to Impaired Response to Interferon-based Therapy for Chronic Hepatitis C

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Insulin Resistance and Diabetes Contribute to Impaired Response to Interferon-based Therapy for Chronic Hepatitis C

Prior research has demonstrated a link between hepatitis C virus (HCV) infection and blood glucose abnormalities such as insulin resistance and types 2 diabetes, but less is known about the impact of glucose abnormalities on response to interferon-based therapy.

As reported in the October 2007 American Journal of Gastroenterology, researchers from Hospital Universitari Vall d'Hebron in Barcelona, Spain, retrospectively analyzed whether impaired fasting glucose and type 2 diabetes influenced the response to antiviral therapy with interferon plus ribavirin in 178 treatment-naive patients with chronic hepatitis C. Fasting plasma glucose was measured prior to starting interferon-based therapy.

Results

• Compared with the 111 non-responders, the 67 patients who achieved sustained virological response (SVR) had lower plasma glucose (94.1 vs 104.4 mg/dL; P= 0.001) and a lower prevalence of glucose abnormalities (24.2% vs 44.1%; P= 0.012). • The SVR rate was 45.1% among the 113 patients with normal blood glucose, 28.3% among the 46 patients with impaired fasting glucose, and 15.8% among the 19 subjects with type 2 diabetes.• Multivariate logistic regression analysis identified HCV genotype 1 (OR 1.55; P= 0.05), GGT level (OR 6.41; P= 0.003), and presence of glucose abnormalities (OR 2.33; P= 0.039) as independent predictors of failure to achieve SVR.• Further, 65 patients with glucose abnormalities had a lower virological response rate when compared with a subgroup of 65 patients with normal blood glucose parameters matched for sex, age, and degree of liver fibrosis (24.6% vs 44.6%, respectively; P= 0.001).

Conclusion

In conclusion, the authors wrote, "Glucose abnormalities are an independent predictor of poor virological response to combined therapy in hepatitis C virus infected patients."

10/12/07

ReferenceA Lecube, C , R Simo, and others. Glucose Abnormalities Are an Independent Risk Factor for Nonresponse to Antiviral Treatment in Chronic Hepatitis C. Am J Gastroenterol 102(10): 2189-2195. October 2007.

http://www.hivandhepatitis.com/hep_c/news/2007/101207_a.html