Insulin resistance is not a relevant predictor of sustained virological response to pegylated interferon plus ribavirin in HIV/HCV co-infected patients

• Published in: Journal of hepatology Vol. 50; no. 4; pp. 684 - 692
• Main Authors: Merchante, Nicolás, de los Santos-Gil, Ignacio, Merino, Dolores, González-Serrano, Mercedes, Mira, José A., Sanz-Sanz, Jesús, Fernández-Fuertes, Elisa, Ruiz-Morales, Josefa, Valle, José del, Macías, Juan, Moro, Antonio, Pineda, Juan A.
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier B.V 01.04.2009; Elsevier
• Subjects: Adult; Antiviral Agents - therapeutic use; Biological and medical sciences; Body Mass Index; Female; Gastroenterology and Hepatology; Gastroenterology. Liver. Pancreas. Abdomen; Hepacivirus - genetics; Hepatitis C - complications; Hepatitis C - drug therapy; HIV Infections - complications; HIV Infections - drug therapy; HIV/HCV co-infection; HOMA; Human viral diseases; Humans; Infectious diseases; Insulin Resistance; Interferon-alpha - therapeutic use; Male; Medical sciences; Pegylated interferon; Polyethylene Glycols - therapeutic use; Predictive Value of Tests; Recombinant Proteins; Retrospective Studies; Ribavirin - therapeutic use; RNA, Viral - blood; SVR; Treatment Outcome; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral hepatitis; Viral Load; EVR; ETR; AOR; Pegylated interferon; CI; IR; ALT; HIV/HCV co-infection; SVR; RVR; HDL; LDL; Insulin resistance; HCV; HOMA; HAART; CHC; BMI; high-density lipoprotein; end of treatment response; adjusted odds ratio; early virological response; sustained virological response; highly active antiretroviral therapy; hepatitis C virus; rapid virological response; insulin resistance; homeostasis model assessment; alanine-aminotransferase; body mass index; chronic hepatitis C; low-density lipoprotein; confidence interval; Endocrinopathy; Immunopathology; Mixed infection; Cytokine; Metabolic diseases; Hepatic disease; AIDS; Immune deficiency; Ribavirin; Infection; Target tissue resistance; Viral disease; Gastroenterology; Nucleoside analog; Digestive diseases; Antiviral; Interferon; Predictive factor; Viral hepatitis C
• ISSN: 0168-8278; 1600-0641; 1600-0641
• DOI: 10.1016/j.jhep.2008.10.032

To evaluate the possible influence of baseline insulin resistance in sustained virological response. One hundred and fifty-five consecutive individuals from a multicentric cohort of HIV/HCV co-infected patients who underwent therapy with pegylated interferon plus ribavirin were included. The main outcome variable was sustained virological response, defined as undetectable plasma HCV RNA at week 24 after the end of the therapy. Insulin resistance was determined using the HOMA method. Sustained virological response was achieved in 55 (36%) patients. Forty-two (38%) patients with a HOMA lower than 4 developed sustained virological response vs 13 (29%) of those with a HOMA above 4 (p=0.27). Analyses restricted to patients harbouring genotype 1 or 4 showed similar rates of sustained virological response among patients with a HOMA below and above 4 [19 (27%) vs 7 (24%); p=0.8]. In the multivariate analysis, genotype 3 [AOR 9.26; 95% CI 3.03–28.30; p<0.0001], a baseline HCV viral load below 600.000IU/mL [AOR 2.97; 95% CI 1.03–8.57; p=0.04] and baseline LDL cholesterol above 100mg/dL [AOR 6.62; 95% CI 1.97–22.19; p=0.002] were independently associated with sustained virological response. Insulin resistance is not a relevant predictor of sustained virological response to pegylated interferon plus ribavirin in HIV/HCV co-infected patients.