scholarly journals The Interaction among Insulin Resistance, Liver Fibrosis and Early Virological Response in Egyptian Patients with Chronic Hepatitis C

2012 ◽  
Vol 26 (6) ◽  
pp. 325-329 ◽  
Author(s):  
Dina H Ziada ◽  
Sherif El Saadany ◽  
Mohamed Enaba ◽  
Medhat Ghazy ◽  
Azza Hasan
Keyword(s):  
Insulin Resistance ◽  
Body Mass Index ◽  
Hepatitis C ◽  
Body Mass ◽  
Virological Response ◽  
Hcv Infection ◽  
Older Age ◽  
Early Virological Response ◽  
Viral Kinetics ◽  
Chronic Hcv

BACKGROUND: Hepatitis C virus (HCV) infection may induce insulin resistance (IR) irrespective of the severity of liver disease, and there is evidence of a central role for IR in failure to achieve sustained virological response (SVR) in HCV patients.OBJECTIVE: To assess IR as a predictor of the severity of hepatic fibrosis in Egyptian HCV patients, and its effect on early viral kinetics and virological response to HCV therapy.METHODS: A total of 140 chronic HCV patients were divided into two groups according to the homeostasis model assessment-IR (HOMA-IR). Group 1 consisted of 48 chronic HCV patients with HOMA-IR ≥2, and group 2 consisted of 92 chronic HVC patients without IR (HOMA IR <2). All patients were treated with combination therapy (pegylated interferon-alpha 2a plus ribavirin) for 48 weeks and studied for viral kinetics throughout the period of therapy.RESULTS: The study revealed that older age, higher body mass index and HOMA-IR≥2 were significantly associated with advanced fibrosis. Rapid virological response, complete early virological response and SVR were significantly lower in the IR-HCV group compared with the non-IR-HCV group. Univariate and multivariate analyses revealed that older age, fibrosis (F≥3), high viral load (>600,000 IU/mL) and HOMA-IR ≥2 were significantly associated with a lack of viral kinetics as well as SVR. However, HOMA-IR ≥2 was the main independent variable associated with lack of SVR. On the other hand, body mass index, plasma insulin level and HOMA-IR decreased significantly compared with starting levels in patients who achieved SVR. This suggests a cause and effect relationship between HCV infection and IR.CONCLUSION: IR in chronic HCV patients is associated with progressive fibrosis and slow viral kinetics, and could be a predictor for lack of rapid and early virological response. Therefore, HOMA-IR levels should be measured and improved before starting antiviral treatment.

scholarly journals Body mass index (BMI) and alpha-fetoprotein (AFP) level correlate with the severity of HCV-induced fibrosis in a cohort of Egyptian patients with chronic HCV

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Amal Ahmed Mohamed ◽  
Amr Ali Hemeda ◽  
Ramy Karam Aziz ◽  
Mohamed Salaheldin Abdel-Hakeem ◽  
Marwa Ali-Tammam
Keyword(s):  
Body Mass Index ◽  
Hepatitis C ◽  
Liver Fibrosis ◽  
Body Mass ◽  
Alpha Fetoprotein ◽  
Hcv Infection ◽  
Hcv Genotype ◽  
Egyptian Patients ◽  
Chronic Hcv ◽  
Severe Fibrosis

Abstract Background Viral hepatitis is the seventh leading cause of mortality globally, and half of this mortality is attributed to hepatitis C virus (HCV). Egypt has the highest HCV prevalence worldwide, with an estimated 14.7% of the population being HCV-positive. HCV infection is the primary cause of liver fibrosis, cirrhosis, and hepatocellular carcinoma. Liver fibrosis varies in severity during chronic HCV infection, and 10–20% of chronic hepatitis C (CHC) patients with severe fibrosis develop cirrhosis. The goal of this work was to assess the clinico-demographic predictors of severity of HCV-induced fibrosis in a cohort of Egyptian patients. Results A cohort of Egyptian patients with chronic HCV genotype 4a infection showed significant association between severe fibrosis stages and obesity, represented by a higher body mass index (BMI), low albumin level, high alpha-fetoprotein (AFP) level, low thyroid-stimulating hormone (TSH) level, and high alkaline phosphatase (ALP) level. Multivariate analysis delineated BMI, TSH, and ALP as independent significant variables that could predict the risk of fibrosis severity in HCV infections. Conclusion This study argues in favor of using the biomarker profile of CHC patients infected with HCV genotype 4a to identify patients at higher risk of developing severe fibrosis, which is a necessary first step towards precision medicine via patient stratification.

scholarly journals Insulin resistance and early virological response in chronic HCV infection

2013 ◽  
Vol 11 (1) ◽  
pp. 69-73
Author(s):  
Wafaa M. Ezzat ◽  
Yasser A. Elhosary ◽  
Nour A. Abdulla ◽  
Hala M. Raslan ◽  
Omneya M. Saleh ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Virological Response ◽  
Hcv Infection ◽  
Early Virological Response ◽  
Chronic Hcv Infection ◽  
Chronic Hcv

Effect of Sustained Virological Response with Direct Acting Antiviral Agents on Insulin Resistance in Patients with Chronic HCV Infection

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mostafa Hamed Abdel-Aleem ◽  
Runia Fouad El-Folly ◽  
Maram Mohamed Maher Mahdy ◽  
Heba Hassan Aly ◽  
Mohamed Mahmoud El-Kassass ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Lipid Profile ◽  
Total Cholesterol ◽  
Virological Response ◽  
Hcv Infection ◽  
Time Points ◽  
Chronic Hcv Infection ◽  
Chronic Hcv

Abstract Background Infection with hepatitis C virus (HCV) is a major cause of chronic hepatitis, cirrhosis and hepatocellular carcinoma worldwide. Liver disease is not the only problem caused by chronic HCV infection; many extra-hepatic complications such as insulin resistance (IR) can be associated with HCV infection as well. Objective To assess the effect of sustained virological response on insulin resistance in patients with chronic hepatitis C infection. Patients and methods This study was conducted in New Cairo Viral Hepatitis Treatment Center (NCVHTC), in the period between December 2017 and December 2018. The current study was conducted on 46 enrolled HCV patients with type 2 Diabetes Mellitus (T2DM). Fasting Insulin (FI) and fasting blood glucose (FBG) as well as lipid profile were assessed in all patients at three time points; before treatment, at the end of treatment (EOT) and 12 weeks after the EOT. Results Despite using 4 different DAA regimens, all patients achieved SVR regardless of the regimen used. As a measurement of IR, HOMA-IR was calculated at the three time points using FI & FBG, it was found that HOMA-IR decreased significantly at the EOT; however, when calculated at week 12 after EOT, the reduction of HOMA-IR was not significant compared to the baseline levels. on the other hand, total cholesterol & LDL increased at the EOT and continued to increase at 12 weeks after the EOT. Conclusion Improvements in IR and glycemic control were not statistically significant after achieving sustained virologic response (SVR) with DAAs in patients with chronic HCV infection. Changes in the lipid profile such as an increase in the levels of total cholesterol and LDL can be expected after treatment with DAAs.

scholarly journals Sustained Virological Response after 8-Week Treatment of Simeprevir with Peginterferon α-2a plus Ribavirin in a Japanese Female with Hepatitis C Virus Genotype 1b and IL28B Minor Genotype

2015 ◽  
Vol 9 (2) ◽  
pp. 215-220 ◽  
Author(s):  
Tatsuo Kanda ◽  
Masato Nakamura ◽  
Reina Sasaki ◽  
Shin Yasui ◽  
Shingo Nakamoto ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Adverse Events ◽  
Sustained Virological Response ◽  
Virological Response ◽  
Hcv Infection ◽  
Direct Acting Antivirals ◽  
Chronic Hcv ◽  
Direct Acting ◽  
Peginterferon Α

Direct-acting antivirals with or without peginterferon α (PEG-IFN α) plus ribavirin are now available for the treatment of hepatitis C virus (HCV) infection. Direct-acting antivirals are potent inhibitors of HCV replication, but some of them occasionally possess serious adverse events. We experienced a 64-year-old female with chronic HCV genotype 1b infection who showed elevated alanine aminotransferase of 528 IU/l at week 9 after the commencement of treatment of simeprevir with PEG-IFN α-2a plus ribavirin. However, she achieved sustained virological response at week 24 after the end of treatment. In Japan, we also have to treat elderly patients infected with HCV and/or advanced hepatic fibrosis. Until an effective interferon-free regimen is established, direct-acting antivirals with PEG-IFN plus ribavirin may still play a role in the treatment for certain patients. To avoid serious results from adverse events, careful attention and follow-up will be needed in the treatment course of simeprevir with PEG-IFN plus ribavirin for chronic HCV infection.

scholarly journals Metabolic Implications of Hepatitis C Virus Infection and it's Correlation to Steatohepatitis in Chronic Hepatitis C Patients with and without Type 2 Diabetes

2010 ◽  
Vol 3 ◽  
pp. IDRT.S3935
Author(s):  
Howaida Elsayed Mansour ◽  
Hanan Mohamed Farouk ◽  
Maryam Ahmad Abdurrahman ◽  
Afaf Abdelaleem Mostafa ◽  
Iman M. Aly Hassan ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Hepatitis C ◽  
Plasma Insulin ◽  
Insulin Level ◽  
Hcv Infection ◽  
Plasma Insulin Level ◽  
Chronic Hcv Infection ◽  
Chronic Hcv

Background Chronic hepatitis C virus (HCV) infection is not a simple viral infection; it has many metabolic and autoimmune complications. Objective To investigate the impacts of chronic HCV infection on glucose and lipid metabolism and its correlation-if any-with body mass index (BMI) and hepatosteatosis in chronic HCV patients. Patients and Methods One hundred and three (103) chronic HCV patients were involved in this study. After blood sugar testing patients were classified into three groups; Group I: 68 chronic HCV patients with type 2 diabetes. Group II: 35 chronic HCV patients without Type 2 Diabetes and Group III: 25 patients with Type 2 Diabetes as a control group. With informed written consents and approval from Ain Shams medical ethics committee, all groups were subjected to the following: full history taking, thorough clinical examination, calculation of BMI, and measurement of the waist/hip ratio were done. Assessment of fasting plasma insulin level was done by the immune-enzymatic method. Assessment of the insulin resistance state was done by Homeostatic Model Assessment (HOMA-IR). Detection of anti-HCV was done by the 3rd generation ELISA test and confirmed by qualitative polymerase chain reaction (PCR). Results Diabetic and non diabetic chronic HCV patients were found to have significantly higher fasting plasma insulin levels and insulin resistance states than the control group. This insulin resistance was not due to increased body mass index as there was a non significant difference in BMI between all the studied groups. Positive correlations were found between plasma insulin level, liver enzymes and steatohepatitis in HCV patients whether they were diabetic or not. No correlation was found between BMI and plasma insulin level in group II patients (HCV only). Conclusion Chronic HCV infection may be regarded as an independent risk factor for the development of insulin resistance and type 2 diabetes. HCV induces insulin resistance; the key step for glucose intolerance, and virus C induced steatohepatitis therefore leading to faster progression to cirrhosis. The impacts of chronic HCV infection on glucose and lipid metabolism should be recognized in clinical care centers and addressed in future studies.

scholarly journals Factors That Influence the Virological Response in Patients with Chronic Hepatitis C Treated with Pegylated Interferon and Ribavirin

PRILOZI ◽  
2017 ◽  
Vol 38 (1) ◽  
pp. 25-33
Author(s):  
Beti Todorovska ◽  
Nenad Joksimovic ◽  
Viktorija Caloska-Ivanova ◽  
Magdalena Dimitrova-Genadieva ◽  
Meri Trajkovska ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Body Mass Index ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Sustained Virological Response ◽  
Chronic Hepatitis C ◽  
Virological Response ◽  
Pegylated Interferon ◽  
Mode Of Transmission ◽  
Inflammatory Changes

Abstract Introduction: The success of the antiviral treatment in patients with chronic hepatitis C depends on the factors related to the virus and the host. The aim of the study is the analysis of the antiviral therapy which is a combination of pegylated interferon and ribavirin, considering various factors that will identify the predictors of the sustained virological response. Material and Methods: This retrospective study included 226 patients, divided in two groups. Patients with sustained virological response and patients without sustained virological response were compared in terms of the following factors: genotype, viral load, gender, age, inflammatory and fibrotic changes in the liver, metabolic abnormalities, obesity and fatty liver. Results: The rate of the sustained virological response is 83.6%, more frequently in patients with genotype 3, with evidenced statistical significance (90.54%). The factors that significantly contribute to sustained virological response are related to the age (p = 0.0001), genotype (p = 0.002), mode of transmission (p = 0.005), inflammatory changes in the liver (p = 0.028), body mass index (p = 0.022) and insulin resistance (p = 0.039). The high rate of sustained virological response is related to the younger age of the patients which indirectly means short Hepatitis C Virus infection duration, absence of advanced liver disease and lack of significant co-morbid conditions. Single confirmed independent predictors of sustained virological response are the age (OR 0.928, p = 0.0001) and genotype (OR 3.134, p = 0.005). Conclusions: Factors that are related to the virological response are the age, genotype, mode of transmission, inflammatory changes in the liver, body mass index and insulin resistance, but still, independent predictors of sustained virologic response are the age and the genotype.

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