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- Title
Insulin resistance predicts sustained virological response to treatment of chronic hepatitis C independently of the IL28b rs12979860 polymorphism.
- Authors
del Campo, J. A.; Ampuero, J.; Rojas, L.; Conde, M.; Rojas, Á.; Maraver, M.; Millán, R.; García‐Valdecasas, M.; García‐Lozano, J. R.; González‐Escribano, M. F.; Romero‐Gómez, M.
- Abstract
Background Insulin resistance has been strongly associated with the attainment of sustained viral response ( SVR) in hepatitis C patients. Aim To determine, in a cohort of Spanish patients with chronic hepatitis C treated with peginterferon plus ribavirin (P+R), whether insulin resistance predicts SVR independently of interleukin-28B rs12979860 polymorphism. Methods Insulin resistance was measured as [ HOMA- IR = Insulin (IU/mL)*glucose (mmol/L)/22.5]. Genotype, viral load and histological fibrosis using Scheuer score were also measured. Binary logistic regression analysis was used for statistical purposes. Results In a cohort of 240 patients [78% genotype 1, 24% showing advanced fibrosis, 71% high viral load (≥800 000 IU/mL), 31% IL28b genotype CC and 50% with HOMA >2] treated with P+R, 126 (53%) reached SVR. HOMA- IR index ( HOMA <2: 63% vs. HOMA >2: 42%; P = 0.001 and IL28b (genotype CC: 68% vs. genotype CT/ TT: 45%; P = 0.002) were significantly associated with SVR. In multivariable logistic regression analysis in the overall cohort, variables independently associated were: viral genotype OR: 0.29 (95% CI: 0.11-0.78), P = 0.01; fibrosis OR: 1.62 (95% CI: 1.22-2.16), P = 0.001; HOMA- IR OR: 1.22 (95% CI: 1.02-1.47), P = 0.03; and IL28B genotype OR: 2.43 (95% CI: 1.45-4.07), P = 0.001. The analyses also showed that degree of steatosis, HOMA- IR >2, mild fibrosis and IL28B CC genotype were significantly related to SVR in patients infected with HCV genotypes 1&4, but not in those with genotypes 2&3. No differences were seen in glucose, insulin level or HOMA- IR index segregated according to IL28B genotypes. Conclusion Our results suggest that insulin resistance, fibrosis stage and IL28B polymorphisms were independent variables associated with sustained viral response.
- Subjects
INSULIN resistance; CHRONIC hepatitis C; VIROLOGY; INTERLEUKINS; RIBAVIRIN; THERAPEUTICS
- Publication
Alimentary Pharmacology & Therapeutics, 2013, Vol 37, Issue 1, p74
- ISSN
0269-2813
- Publication type
Article
- DOI
10.1111/apt.12113