Clearance of HCV by Combination Therapy of Pegylated Interferon Alpha-2a and Ribavirin Improves Insulin Resistance

Overview

Journal Gut Liver

Specialty Gastroenterology

Date 2010 May 1

PMID 20431732

Citations 9

Authors

Hong Joo Kim

Jung Ho Park

Dong Il Park

Yong Kyun Cho

Chong Il Sohn

Woo Kyu Jeon

Byung Ik Kim

Affiliations

Soon will be listed here.

Abstract

Background/aims: Chronic hepatitis C virus (HCV) infection is associated with a higher risk of the development of insulin resistance. If HCV is a causal factor for insulin resistance, then clearance of HCV might decrease insulin resistance. The aim of this study was to elucidate the effects of clearance of HCV on insulin resistance.

Methods: We analyzed 28 patients with HCV infection who received combination treatment of 180 microg of pegylated interferon alpha-2a and ribavirin at our institution from May 2004 to November 2006. Insulin resistance was calculated according to the homeostasis model assessment of insulin resistance (HOMA-IR) method.

Results: Twenty-two patients (78.6%) achieved sustained virologic response (SVR), where the fasting plasma glucose level significantly decreased after antiviral treatment. Fasting serum insulin and HOMA-IR also significantly decreased after antiviral treatment, whereas the BMI value was not significantly affected. For the nonresponders (n=6), no significant changes were evident in BMI, fasting plasma glucose, fasting serum insulin, and HOMA-IR at 6 months after the end of antiviral treatment. Logistic regression analysis indicated that the only independent factor contributing to the reduction of insulin resistance was the complete disappearance of HCV RNA at 6 months after the end of antiviral treatment (SVR).

Conclusions: The clearance of HCV by the combination therapy of pegylated interferon alpha-2a and ribavirin improves insulin resistance by reducing fasting serum insulin and glucose levels.

Citing Articles

Effect of HCV treatment response on insulin resistance: A systematic review and meta-analysis.

Hu J, Chang M, Liu N, Yeh C, Huang T Exp Ther Med. 2019; 18(5):3568-3578.

PMID: 31602234 PMC: 6777273. DOI: 10.3892/etm.2019.7995.

Significant HbA Lowering in Patients Achieving a Hepatitis C Virus Cure.

Rife K, Lyman A, LeClerc-Kamieniecki S, Falck-Ytter C, Pascuzzi K, Burant C Fed Pract. 2019; 36(Suppl 2):S26-S32.

PMID: 30983858 PMC: 6453605.

Diabetes mellitus, insulin resistance and hepatitis C virus infection: A contemporary review.

Desbois A, Cacoub P World J Gastroenterol. 2017; 23(9):1697-1711.

PMID: 28321170 PMC: 5340821. DOI: 10.3748/wjg.v23.i9.1697.

Retrospective study of the associations between hepatitis C virus infection and metabolic factors.

Yair-Sabag S, Nussinson E, Ben-Assuli O, Shibli F, Shahbari A, Zelber-Sagi S World J Hepatol. 2016; 8(30):1269-1278.

PMID: 27843537 PMC: 5084056. DOI: 10.4254/wjh.v8.i30.1269.

Hepatitis C Virus, Insulin Resistance, and Steatosis.

Kralj D, Virovic Jukic L, Stojsavljevic S, Duvnjak M, Smolic M, Curcic I J Clin Transl Hepatol. 2016; 4(1):66-75.

PMID: 27047774 PMC: 4807145. DOI: 10.14218/JCTH.2015.00051.

References

Mason A, Lau J, Hoang N, Qian K, Alexander G, Xu L . Association of diabetes mellitus and chronic hepatitis C virus infection. Hepatology. 1999; 29(2):328-33. DOI: 10.1002/hep.510290235. View

Sumie S, Kawaguchi T, Komuta M, Kuromatsu R, Itano S, Okuda K . Significance of glucose intolerance and SHIP2 expression in hepatocellular carcinoma patients with HCV infection. Oncol Rep. 2007; 18(3):545-52. View

Tai T, Lu J, Chen C, Lai M, Chen P, Kao J . Interferon-alpha reduces insulin resistance and beta-cell secretion in responders among patients with chronic hepatitis B and C. J Endocrinol. 2003; 178(3):457-65. DOI: 10.1677/joe.0.1780457. View

Adami H, Chow W, Nyren O, Berne C, Linet M, Ekbom A . Excess risk of primary liver cancer in patients with diabetes mellitus. J Natl Cancer Inst. 1996; 88(20):1472-7. DOI: 10.1093/jnci/88.20.1472. View

Simmonds P, Holmes E, Cha T, Chan S, McOmish F, Irvine B . Classification of hepatitis C virus into six major genotypes and a series of subtypes by phylogenetic analysis of the NS-5 region. J Gen Virol. 1993; 74 ( Pt 11):2391-9. DOI: 10.1099/0022-1317-74-11-2391. View

Koivisto V, PELKONEN R, Cantell K . Effect of interferon on glucose tolerance and insulin sensitivity. Diabetes. 1989; 38(5):641-7. DOI: 10.2337/diab.38.5.641. View

Bahtiyar G, Shin J, Aytaman A, Sowers J, McFarlane S . Association of diabetes and hepatitis C infection: epidemiologic evidence and pathophysiologic insights. Curr Diab Rep. 2004; 4(3):194-8. DOI: 10.1007/s11892-004-0023-7. View

Kawaguchi T, Nagao Y, Tanaka K, Ide T, Harada M, Kumashiro R . Causal relationship between hepatitis C virus core and the development of type 2 diabetes mellitus in a hepatitis C virus hyperendemic area: a pilot study. Int J Mol Med. 2005; 16(1):109-14. View

El-Serag H, Tran T, Everhart J . Diabetes increases the risk of chronic liver disease and hepatocellular carcinoma. Gastroenterology. 2004; 126(2):460-8. DOI: 10.1053/j.gastro.2003.10.065. View

10.

Hui J, Sud A, Farrell G, Bandara P, Byth K, Kench J . Insulin resistance is associated with chronic hepatitis C virus infection and fibrosis progression [corrected]. Gastroenterology. 2004; 125(6):1695-704. DOI: 10.1053/j.gastro.2003.08.032. View

11.

Allison M, Wreghitt T, Palmer C, Alexander G . Evidence for a link between hepatitis C virus infection and diabetes mellitus in a cirrhotic population. J Hepatol. 1994; 21(6):1135-9. DOI: 10.1016/s0168-8278(05)80631-2. View

12.

Shintani Y, Fujie H, Miyoshi H, Tsutsumi T, Tsukamoto K, Kimura S . Hepatitis C virus infection and diabetes: direct involvement of the virus in the development of insulin resistance. Gastroenterology. 2004; 126(3):840-8. DOI: 10.1053/j.gastro.2003.11.056. View

13.

Nagao Y, Kawaguchi T, Tanaka K, Kumashiro R, Sata M . Extrahepatic manifestations and insulin resistance in an HCV hyperendemic area. Int J Mol Med. 2005; 16(2):291-6. View

14.

Moucari R, Asselah T, Cazals-Hatem D, Voitot H, Boyer N, Ripault M . Insulin resistance in chronic hepatitis C: association with genotypes 1 and 4, serum HCV RNA level, and liver fibrosis. Gastroenterology. 2008; 134(2):416-23. DOI: 10.1053/j.gastro.2007.11.010. View

15.

Ito Y, Takeda N, Ishimori M, Akai A, Miura K, Yasuda K . Effects of long-term interferon-alpha treatment on glucose tolerance in patients with chronic hepatitis C. J Hepatol. 1999; 31(2):215-20. DOI: 10.1016/s0168-8278(99)80216-5. View

16.

Kawaguchi T, Ide T, Taniguchi E, Hirano E, Itou M, Sumie S . Clearance of HCV improves insulin resistance, beta-cell function, and hepatic expression of insulin receptor substrate 1 and 2. Am J Gastroenterol. 2007; 102(3):570-6. DOI: 10.1111/j.1572-0241.2006.01038.x. View

17.

Imano E, Kanda T, Ishigami Y, Kubota M, Ikeda M, Matsuhisa M . Interferon induces insulin resistance in patients with chronic active hepatitis C. J Hepatol. 1998; 28(2):189-93. DOI: 10.1016/0168-8278(88)80004-7. View

18.

Harrison S . Correlation between insulin resistance and hepatitis C viral load. Hepatology. 2006; 43(5):1168. DOI: 10.1002/hep.21125. View

19.

Konrad T, Zeuzem S, Vicini P, Toffolo G, Briem D, Lormann J . Evaluation of factors controlling glucose tolerance in patients with HCV infection before and after 4 months therapy with interferon-alpha. Eur J Clin Invest. 2000; 30(2):111-21. DOI: 10.1046/j.1365-2362.2000.00608.x. View

20.

Kawaguchi T, Yoshida T, Harada M, Hisamoto T, Nagao Y, Ide T . Hepatitis C virus down-regulates insulin receptor substrates 1 and 2 through up-regulation of suppressor of cytokine signaling 3. Am J Pathol. 2004; 165(5):1499-508. PMC: 1618659. DOI: 10.1016/S0002-9440(10)63408-6. View