Changes in insulin sensitivity and body weight during and after peginterferon and ribavirin therapy for hepatitis C LIVER NEWS ELSEWHERE

Mohammed Eslam, Reyes Aparcero, Manuel Romero Gomez, Manuel Romero-Gómez
2011 Changes in insulin sensitivity and body weight   unpublished
Article commented: Conjeevaram HS, Wahed AS, Afdhal N, Howell CD, Everhart JE, Hoofnagle JH; Virahep-C Study Group. Changes in insulin sensitivity and body weight during and after peginterferon and riba-virin therapy for hepatitis C. Gastroenterology 2011;140:469-77 Original abstract Background & aims. Chronic hepatitis C is associated with an increased prevalence of insulin resistance , which might result from liver disease, metabolic factors, or the hepatitis C virus (HCV) itself. The effect
more » ... itself. The effect of antiviral treatment on insulin sensitivity is not well known. We evaluated changes in insulin resistance and weight in patients with hepatitis C during and after peginterferon and ribavirin therapy. Methods. Virahep-C was a prospective , multi-center study of a 48-week course of combination antiviral therapy in patients infected with HCV genotype 1. Insulin resistance was estimated by the homeostasis model assessment index (HOMA2-IR) based on fasting glucose and insulin levels. Results. Among 341 patients, 40% had insulin resistance (HOMA2-IR > 2.0). The presence of insulin resistance was associated with increasing age, body mass index, (BMI) and fibrosis stage. Among patients with insulin resistance at the start of the trial, median decreases in HOMA2-IR values during treatment were 0.74 at 24 weeks and 0.89 at 48 weeks, whereas BMI decreased by 1.2 and 2.2 kg/m 2 at the same timepoints (P < 0.001
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