Open AccessPilot Study of Pioglitazone Before HCV Retreatment in HIV/HCV Genotype 1–Infected Subjects With Insulin Resistance and Previous Nonresponse to Peginterferon and Ribavirin Therapy
Author(s) -
Kristen Marks,
Douglas Kitch,
Raymond T. Chung,
Colleen Hadigan,
Janet Andersen,
Phyllis C. Tien,
Annie Luetkemeyer,
Beverly Alston-Smith,
Marshall J. Glesby
Publication year - 2014
Publication title -
journal of acquired immune deficiency syndromes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.162
H-Index - 157
eISSN - 1944-7884
pISSN - 1525-4135
DOI - 10.1097/qai.0000000000000073
Subject(s) - ribavirin , pioglitazone , medicine , hepatitis c virus , insulin resistance , gastroenterology , hepatitis c , homeostatic model assessment , confidence interval , hepacivirus , alanine transaminase , insulin , virology , endocrinology , diabetes mellitus , type 2 diabetes , virus
: Insulin resistance is associated with nonresponse to hepatitis C virus (HCV) treatment. In this multicenter, single-arm pilot study, adult, HIV/HCV genotype 1-coinfected previous nonresponders to peginterferon/ribavirin (PegIFN/RBV) with homeostatic model assessment of insulin resistance >2.5 were treated with pioglitazone (PIO) for 24 weeks followed by PegIFN/RBV/PIO. Three of 19 subjects (15.8%) achieved undetectable HCV RNA at week 24 of PegIFN/RBV/PIO, which was not significantly different than the historical null rate of 10% (P = 0.29, lower limit of the exact 1-sided 90% confidence interval 5.9%). Over the 24 weeks of PIO monotherapy, alanine aminotransferase and aspartate aminotransferase declined significantly and correlated with improved metabolic parameters.