Clinical Implication of Insulin Resistance in Chronic Hepatitis C Patients

Research output: Contribution to journalReview article

Abstract

Chronic hepatitis C virus (HCV) infection is the leading cause for the development of liver cirrhosis and hepatocellular carcinoma, however, it also causes metabolic disorders. Insulin resistance is representative of these metabolic disorders, and not only leads to the development of diabetes but also affects the outcome of antiviral treatment with interferon. Historically, the standard of care for chronic HCV infection was pegylated interferon and ribavirin, but only 40-50% of HCV genotype 1 patients achieve a sustained virological response (SVR). We successfully established a pretreatment prediction model for the treatment outcome using a homeostasis model assessment of insulin resistance (HOMA-IR) and the interleukin 28B genotype (rs 8099917). In recent years, antiviral agents targeting viral proteins critical for HCV replication have become available. Of these, telaprevir, an HCV NS3/4A serine protease inhibitor, has been available in Japan since 2011. As a result, about 80% of patients with HCV genotype 1 can achieve SVR. Nonetheless, insulin resistance is associated with treatment failure, especially for difficult-to-treat patients. In the near future, almost all patients with chronic HCV infection will achieve virological clearance with combined direct antiviral agents, however, insulin resistance will remain a risk for hepatocellular carcinoma. Therefore, the prevention of obesity and avoidance of excessive alcohol intake are very important after achieving SVR.

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalKansenshōgaku zasshi. The Journal of the Japanese Association for Infectious Diseases
Volume89
Issue number1
DOIs
Publication statusPublished - Jan 1 2015

Fingerprint

Chronic Hepatitis C
Hepacivirus
Insulin Resistance
Virus Diseases
Antiviral Agents
Genotype
Interferons
Hepatocellular Carcinoma
Serine Proteinase Inhibitors
Ribavirin
Interleukins
Viral Proteins
Standard of Care
Virus Replication
Treatment Failure
Liver Cirrhosis
Japan
Homeostasis
Obesity
Alcohols

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

@article{fae03c6e85de4a9e814ae630b820c01e,
title = "Clinical Implication of Insulin Resistance in Chronic Hepatitis C Patients",
abstract = "Chronic hepatitis C virus (HCV) infection is the leading cause for the development of liver cirrhosis and hepatocellular carcinoma, however, it also causes metabolic disorders. Insulin resistance is representative of these metabolic disorders, and not only leads to the development of diabetes but also affects the outcome of antiviral treatment with interferon. Historically, the standard of care for chronic HCV infection was pegylated interferon and ribavirin, but only 40-50{\%} of HCV genotype 1 patients achieve a sustained virological response (SVR). We successfully established a pretreatment prediction model for the treatment outcome using a homeostasis model assessment of insulin resistance (HOMA-IR) and the interleukin 28B genotype (rs 8099917). In recent years, antiviral agents targeting viral proteins critical for HCV replication have become available. Of these, telaprevir, an HCV NS3/4A serine protease inhibitor, has been available in Japan since 2011. As a result, about 80{\%} of patients with HCV genotype 1 can achieve SVR. Nonetheless, insulin resistance is associated with treatment failure, especially for difficult-to-treat patients. In the near future, almost all patients with chronic HCV infection will achieve virological clearance with combined direct antiviral agents, however, insulin resistance will remain a risk for hepatocellular carcinoma. Therefore, the prevention of obesity and avoidance of excessive alcohol intake are very important after achieving SVR.",
author = "Eiichi Ogawa",
year = "2015",
month = "1",
day = "1",
doi = "10.11150/kansenshogakuzasshi.89.1",
language = "English",
volume = "89",
pages = "1--9",
journal = "Nippon Densenbyo Gakkai zasshi",
issn = "0387-5911",
publisher = "Nihon Kansensho Gakkai",
number = "1",

}

TY - JOUR

T1 - Clinical Implication of Insulin Resistance in Chronic Hepatitis C Patients

AU - Ogawa, Eiichi

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Chronic hepatitis C virus (HCV) infection is the leading cause for the development of liver cirrhosis and hepatocellular carcinoma, however, it also causes metabolic disorders. Insulin resistance is representative of these metabolic disorders, and not only leads to the development of diabetes but also affects the outcome of antiviral treatment with interferon. Historically, the standard of care for chronic HCV infection was pegylated interferon and ribavirin, but only 40-50% of HCV genotype 1 patients achieve a sustained virological response (SVR). We successfully established a pretreatment prediction model for the treatment outcome using a homeostasis model assessment of insulin resistance (HOMA-IR) and the interleukin 28B genotype (rs 8099917). In recent years, antiviral agents targeting viral proteins critical for HCV replication have become available. Of these, telaprevir, an HCV NS3/4A serine protease inhibitor, has been available in Japan since 2011. As a result, about 80% of patients with HCV genotype 1 can achieve SVR. Nonetheless, insulin resistance is associated with treatment failure, especially for difficult-to-treat patients. In the near future, almost all patients with chronic HCV infection will achieve virological clearance with combined direct antiviral agents, however, insulin resistance will remain a risk for hepatocellular carcinoma. Therefore, the prevention of obesity and avoidance of excessive alcohol intake are very important after achieving SVR.

AB - Chronic hepatitis C virus (HCV) infection is the leading cause for the development of liver cirrhosis and hepatocellular carcinoma, however, it also causes metabolic disorders. Insulin resistance is representative of these metabolic disorders, and not only leads to the development of diabetes but also affects the outcome of antiviral treatment with interferon. Historically, the standard of care for chronic HCV infection was pegylated interferon and ribavirin, but only 40-50% of HCV genotype 1 patients achieve a sustained virological response (SVR). We successfully established a pretreatment prediction model for the treatment outcome using a homeostasis model assessment of insulin resistance (HOMA-IR) and the interleukin 28B genotype (rs 8099917). In recent years, antiviral agents targeting viral proteins critical for HCV replication have become available. Of these, telaprevir, an HCV NS3/4A serine protease inhibitor, has been available in Japan since 2011. As a result, about 80% of patients with HCV genotype 1 can achieve SVR. Nonetheless, insulin resistance is associated with treatment failure, especially for difficult-to-treat patients. In the near future, almost all patients with chronic HCV infection will achieve virological clearance with combined direct antiviral agents, however, insulin resistance will remain a risk for hepatocellular carcinoma. Therefore, the prevention of obesity and avoidance of excessive alcohol intake are very important after achieving SVR.

UR - http://www.scopus.com/inward/record.url?scp=84952720267&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84952720267&partnerID=8YFLogxK

U2 - 10.11150/kansenshogakuzasshi.89.1

DO - 10.11150/kansenshogakuzasshi.89.1

M3 - Review article

C2 - 26548290

AN - SCOPUS:84952720267

VL - 89

SP - 1

EP - 9

JO - Nippon Densenbyo Gakkai zasshi

JF - Nippon Densenbyo Gakkai zasshi

SN - 0387-5911

IS - 1

ER -