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The homeostasis model assessment of the insulin resistance score is not predictive of a sustained virological response in chronic hepatitis C patients
Author(s) -
Fattovich Giovanna,
Covolo Loredana,
Pasino Michela,
Perini Eleonora,
Rossi Luigi,
Brocco Giorgio,
Guido Maria,
Cristofori Chiara,
Belotti Caterina,
Puoti Massimo,
Gaeta Giovanni Battista,
Santantonio Teresa,
Raimondo Giovanni,
Bruno Raffaele,
Minola Eliseo,
Negro Francesco,
Donato Francesco
Publication year - 2011
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2010.02343.x
Subject(s) - medicine , ribavirin , insulin resistance , gastroenterology , genotype , pegylated interferon , metabolic syndrome , alanine transaminase , cohort , body mass index , homeostatic model assessment , hepatitis c virus , immunology , insulin , biology , virus , obesity , biochemistry , gene
Objectives: To investigate the independent association between the homeostasis model assessment of the insulin resistance (HOMA‐IR) score and rapid virological response (RVR) and sustained virological response (SVR) in chronic hepatitis C (CHC). Methods: Observational prospective cohort study of 412 CHC patients [59% males; mean age 45 years; genotype 1 (44%), 2 (32%), 3 (19%) and 4 (5%)] treated with pegylated interferon α plus ribavirin. Results: A HOMA‐IR ≥2.0 was present in 49% and a metabolic syndrome in 4% of patients. By multivariate analysis, independent predictors of SVR were the lack of advanced fibrosis (≥F3) in genotype 1 and a lower body mass index in genotype 3 patients. In the subgroup of patients in whom HCV‐RNA was evaluated at week 4 ( n =281), independent predictors of RVR were HCV‐RNA <700 000 IU/ml, age <40 years and lower aspartate aminotransferase:alanine aminotransferase ratio in genotype 1 and baseline HOMA‐IR ≤2 in genotype 3 patients. No predictive factor of RVR was identified among genotype 2 patients. RVR was the strongest predictor of SVR among genotype 1 or 3 patients. Conclusions: In this series of treatment‐naïve, Caucasian CHC patients at a low risk for the metabolic syndrome, HOMA‐IR is not a predictor of SVR, irrespective of the HCV genotype, although it may predict RVR in genotype 3 infection.