Insulin Resistance Not Linked with Fibrosis Progression in Coinfected Patients

Research has shown that insulin resistance is a common condition among people with chronic hepatitis C, and some studies have also shown that it is associated with liver fibrosis progression.

As reported in the July 2006 Journal of Viral Hepatitis, Spanish researchers aimed to determine whether there was an association between insulin resistance and fibrosis progression in HIV/HCV coinfected individuals. They conducted a cross-sectional study of 79 coinfected patients who underwent liver biopsy, had available frozen serum samples at the time of biopsy, and had a known or estimated date of infection.

Results

Age at HCV infection (older than 21 years) was the only variable independently associated with advanced liver fibrosis (stages F3 and F4) (adjusted odds ratio 4.15; 95% CI).

Variables associated with a faster-than-average fibrosis progression rate were:

- Age greater than 21 years at the time of HCV infection (AOR 6.41; 95% CI 2.16-27.96)

- Previous use of nevirapine (Viramune) (AOR 8.9; 95% CI 2.01-39.36).

There was no association between insulin resistance measured using the homeostasis model assessment method (HOMA-IR) and the presence of advanced fibrosis or a faster fibrosis progression rate .

Conclusion

The authors concluded that insulin resistance "is not associated with liver damage or fibrosis progression in HIV/HCV-coinfected individuals."

Further study is needed to explain the discrepancy between these results and those of previous studies that have found such an association in HCV monoinfected individuals.

7/25/06

Reference
M Merchante, J Macias, E Ramayo, and others. Insulin Resistance is Not Associated with Liver Fibrosis Progression in HIV/Hepatitis C Virus-Coinfected Patients. Journal of Viral Hepatitis 13(7): 449-56. July 2006.