Clin Mol Hepatol.  2014 Mar;20(1):38-46. 10.3350/cmh.2014.20.1.38.

The impact of pegylated interferon and ribavirin combination treatment on lipid metabolism and insulin resistance in chronic hepatitis C patients

• Jung HJ
• Kim YS
• Kim SG
• Lee YN
• Jeong SW
• Jang JY
• Lee SH
• Kim HS
• Kim BS

• KMID: 1737597
• DOI: http://doi.org/10.3350/cmh.2014.20.1.38

Abstract

BACKGROUND/AIMS
Lipid profile and insulin resistance (IR) are associated with hepatitis C virus (HCV) and may predict the chronic hepatitis C (CHC) treatment response. The aim of this study was to determine the association between CHC treatment response and lipid profile and IR change during treatment.
METHODS
In total, 203 CHC patients were reviewed retrospectively between January 2005 and December 2011 at Soon Chun Hyang University Hospital. The lipid profile, homeostasis model for assessment (HOMA) of IR (HOMA-IR), and HOMA of beta cells (HOMA-beta) were evaluated before interferon plus ribavirin therapy (BTx), at the end of treatment (DTx), and 24 weeks after the end of treatment (ATx).
RESULTS
A sustained virologic response (SVR) was achieved by 81% of all patients (49/60), 60% (n=36) of whom possessed genotype 1, with the remainder being non-genotype-1 (40%, n=24). Apart from age, which was significantly higher in the non-SVR group (SVR, 48.0+/-11.2 years, mean+/-SD; non-SVR, 56.6+/-9.9 years; P<0.01), there were no significant differences in the baseline characteristics between the SVR and non-SVR groups. In the SVR group, low density lipoprotein-cholesterol (LDL-C) had significantly changed at DTx and ATx compared to BTx. In addition, HOMA-IR and HOMA-beta were significantly changed at DTx in the SVR group. Among those with a high baseline insulin resistance (HOMA-IR >2.5), HOMA-IR was significantly changed at DTx in the SVR group.
CONCLUSIONS
LDL-C appears to be associated with HCV treatment in SVR patients. Furthermore, eradication of HCV may improve whole-body IR and insulin hypersecretion, as well as high baseline insulin resistance (HOMA-IR >2.5).

Keyword

Lipid metabolism; Insulin resistance; Chronic hepatitis C

MeSH Terms

Adult
Aged
Antiviral Agents/pharmacology/*therapeutic use
Cholesterol/blood
Drug Therapy, Combination
Female
Genotype
Hepacivirus/genetics
Hepatitis C, Chronic/*drug therapy
Humans
*Insulin Resistance
Interferon-alpha/pharmacology/*therapeutic use
Lipid Metabolism/drug effects
Male
Middle Aged
Polyethylene Glycols/pharmacology/*therapeutic use
Recombinant Proteins/pharmacology/therapeutic use
Ribavirin/*therapeutic use
Treatment Outcome
Triglycerides/blood
Antiviral Agents
Cholesterol
Interferon-alpha
Polyethylene Glycols
Recombinant Proteins
Triglycerides
Ribavirin