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Sustained virological response following chronic hepatitis C treatment is associated with improvement in insulin resistance
Author(s) -
Chan C. H. Y.,
Hansen R. D.,
Gilliver R. S.,
Jones B. E.
Publication year - 2013
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.12136
Subject(s) - medicine , insulin resistance , steatosis , gastroenterology , fibrosis , hepatitis c virus , alanine aminotransferase , chronic hepatitis , homeostasis , hepatic fibrosis , insulin , immunology , virus
Background 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 . Aim The aim of this study was to determine the impact of viral clearance on IR . Methods Eighty‐six patients treated according to standard clinical practice at an A ustralian teaching hospital between 2003 and 2007 were prospectively studied. Demographic, biochemical and histological data were collected. Results 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, P = 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 ( P = 0.01). Conclusions 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.