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Prior assessment of insulin resistance by HOMA-IR is emerging as an important milestone in the treatment of patients with
chronic hepatitis C. This cost-effective tool is recommended to individualize treatment duration, or to exclude those with
low insulin sensitivity from being treated until ameliorating their state of insulin resistance (IR). The present work aims to
elucidate further the effect IR state on early viral kinetic response to Chronic hepatitis C virus (HCV) therapy and the impact
of HCV treatment and viral eradication on insulin sensitivity. Insulin sensitivity was assessed using the HOMA-IR method.
All enrolled patients were treated with a dual therapy (pegylated interferon-alpha plus ribavirin) for 48 weeks and evaluated
using qRT-PCR for early virologic response as well as the impact of treatment on insulin sensitivity throughout the early period
of therapy. Of a total 392 chronic HCV cases, early virologic response was achieved by 318 (81.1%). IR was detected in 241
(61.5%) chronic HCV patient of which 73.4% responded to treatment. Early virologic responses among patients with >2.18
HOMA-IR value were significantly lower than those with HOMA-IR values ≤2.18 (P < 0.0001). IR was significantly associated
with high baseline BMI. Steatosis and fibrosis correlated with IR but neither independently predicted early virologic response.
Pretreatment IR <2.18, low fasting blood glucose, low and intermediate HCV viral load, normal BMI, and non-smoking were
independent factors associated with early virologic response. IR interferes with early virologic response to the antiviral care.
Clinical application of pretreatment HOMA-IR assessment could help in predicting early treatment outcome and thus enable
treatment regimens to be optimized and individually tailored.
Ekram Wassim Abd El- Wahab is currently working as an eminent faculty member at Tropical Health Department, High Institute of Public Health in Alexandria University, Egypt. He has published numerous research papers and articles in reputed journals and has various other achievements in the related studies. He has extended his valuable service towards the scientific community with his extensive research work.