Insulin resistance and HCV virologic response to peg-interferons (Peg-IFN) with ribavirin (RBV) in HIV/HCV co-infected patients

Abstract

Reference[1] Grasso A, Malfatti F, De Leo P, Martines H, Fabris P, Toscanini F, et al. Insulin resistance predicts rapid virological response in non-diabetic, non-cirrhotic genotype 1 HCV patients treated with peginterferon alpha-2b plus ribavirin.

Pilot Study of Pioglitazone Before HCV Retreatment in HIV/HCV Genotype 1–Infected Subjects With Insulin Resistance and Previous Nonresponse to Peginterferon and Ribavirin Therapy

“…Relapsers were excluded. Insulin resistance was defined as homeostatic model assessment of insulin resistance (HOMA-IR) value of >2.5 (calculated as fasting serum insulin (µU/mL) x fasting plasma glucose (mg/dL)/405), consistent with many other studies of insulin resistance and HCV treatment 1;2;11;13-15 . Subjects with diabetes, fasting plasma glucose ≥126 mg/dL, or on antidiabetic medications were excluded.…”

Current treatment for chronic hepatitis C virus/HIV-infected individuals

“…The data on insulin resistance and response to peg-IFN/RBV appear conflicting. Although in some evaluations insulin resistance is independently associated with a reduced rapid virological response (RVR, undetectable HCV RNA at week 4) and SVR in both treatment naïve [24,25] and SVR in re-treatment of HCV in co-infected patients [26], others have demonstrated no effect of insulin resistance on SVRs [27,28]. Whether insulin resistance is a surrogate for advanced fibrosis or associated with particular ART regimen and thus a confounder in this relationship remains to be elucidated.…”