Improved Insulin Resistance with Clearance of Chronic Hepatitis C, Genotype 4

Background and Aim: Greater insulin resistance (IR) is more prevalent among patients with Chronic hepatitis C virus (HCV) infection compared with those with other liver diseases and with the general population. IR affects HCV disease progress and response to treatment. The effect of HCV geno-type 4 clearance on IR was prospectively evaluated. Methods: Sixty two patients with chronic hepatitis C (CHC), genotype 4, treated with pegylated interferon-alpha-2a plus ribavirin, were classified into three groups according to response to therapy. Group I (sustained responders): 44 patients responded to treatments and had sustained virological response (SVR). Group II (non responders): 13 non responders with RNA still positive after 12 weeks therapy. Group III (relapsers): 5 who had undetectable HCV-RNA at the end of antiviral therapy but HCV-RNA relapse during follow-up (6 months after one year therapy). IR was assessed by the Homeostasis model for assessment of insulin resistance (HOMA-IR) method before and after treatment. Results: Non of our patients were diabetic, cirrhotic, alcoholic or markedly obese. Baseline data of the three groups were comparable, with no significant statistical differences. HOMA-IR six months was decreased after treatment in the three groups, but significant only in group I. Conclusion: In genotype 4 SVR decreases insulin resis-tance significantly, and such effect is not noted in non responder or relapsers.