Reduction of Insulin Resistance With Effective Clearance of Hepatitis C Infection: Results From the HALT-C Trial

Aymin Delgado-Borrego, Sergio H. Jordan, Betania Negre, David Healey, Wenyu Lin, Yoshitaka Kamegaya, Marielle Christofi, David Ludwig, Anna S F Lok, Raymond T. Chung

Research output: Contribution to journalArticle

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Abstract

Background & Aims: Hepatitis C virus (HCV) infection is associated with an increased prevalence of diabetes and insulin resistance (IR); whether this is a causal relationship has not been established. Methods: We performed a longitudinal study within the lead-in phase of the Hepatitis C Antiviral Long-Term Treatment against Cirrhosis (HALT-C) Trial to evaluate whether suppression of hepatitis C is associated with improvement in IR. Participants had advanced hepatic fibrosis and carried non-3 HCV genotypes (n = 96). Patients underwent 24 weeks of pegylated interferon and ribavirin therapy and were categorized into HCV clearance groups at week 20 on the basis of HCV RNA levels; null responders had <1 log10 decline (n = 38), partial responders had ≥1 log10 decline (n = 37) but detectable HCV RNA, and complete responders had no detectable HCV RNA (n = 21). The primary outcome was change (week 20 minus week 0) in IR by using the homeostasis model assessment (HOMA2-IR). Results: Adjusting only for baseline HOMA2-IR, mean HOMA2-IR differences were -2.23 (complete responders), -0.90 (partial responders), and +0.18 (null responders) (P = .036). The observed differences in mean HOMA2-IR scores were ordered in a linear fashion across response groups (P = .01). The association between HCV clearance and improvement in HOMA2-IR could not be accounted for by adiponectin or tumor necrosis factor-alpha and was independent of potential confounders including age, gender, ethnicity, body mass index, duration of infection, medications used, and fibrosis. Conclusions: HCV suppression correlates with improvement in IR. These data provide further support for a role of HCV in the development of insulin resistance.

Original languageEnglish
Pages (from-to)458-462
Number of pages5
JournalClinical Gastroenterology and Hepatology
Volume8
Issue number5
DOIs
StatePublished - May 1 2010

Fingerprint

Hepatitis C
Antiviral Agents
Insulin Resistance
Hepacivirus
Fibrosis
Infection
Therapeutics
RNA
Ribavirin
Adiponectin
Virus Diseases
Interferons
Longitudinal Studies
Body Mass Index
Homeostasis
Tumor Necrosis Factor-alpha
Genotype
Liver

Keywords

  • Adiponectin
  • Cirrhosis
  • HALT-C
  • HOMA
  • Interferon

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Reduction of Insulin Resistance With Effective Clearance of Hepatitis C Infection : Results From the HALT-C Trial. / Delgado-Borrego, Aymin; Jordan, Sergio H.; Negre, Betania; Healey, David; Lin, Wenyu; Kamegaya, Yoshitaka; Christofi, Marielle; Ludwig, David; Lok, Anna S F; Chung, Raymond T.

In: Clinical Gastroenterology and Hepatology, Vol. 8, No. 5, 01.05.2010, p. 458-462.

Research output: Contribution to journalArticle

Delgado-Borrego, A, Jordan, SH, Negre, B, Healey, D, Lin, W, Kamegaya, Y, Christofi, M, Ludwig, D, Lok, ASF & Chung, RT 2010, 'Reduction of Insulin Resistance With Effective Clearance of Hepatitis C Infection: Results From the HALT-C Trial', Clinical Gastroenterology and Hepatology, vol. 8, no. 5, pp. 458-462. https://doi.org/10.1016/j.cgh.2010.01.022
Delgado-Borrego, Aymin ; Jordan, Sergio H. ; Negre, Betania ; Healey, David ; Lin, Wenyu ; Kamegaya, Yoshitaka ; Christofi, Marielle ; Ludwig, David ; Lok, Anna S F ; Chung, Raymond T. / Reduction of Insulin Resistance With Effective Clearance of Hepatitis C Infection : Results From the HALT-C Trial. In: Clinical Gastroenterology and Hepatology. 2010 ; Vol. 8, No. 5. pp. 458-462.
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