Clinical

Hyperglycemia tied to poor response to HCV therapy

Last Updated: 2007-11-30 17:49:29 -0400 (Reuters Health)

By David Douglas

NEW YORK (Reuters Health) - Glucose abnormalities are an independent risk factor for failure to respond to antiviral treatment in patients with chronic hepatitis C virus (HCV) infection, according to Spanish researchers.

"The relationship between hyperglycemia and the reduced treatment response in HCV-infected patients has several implications," lead investigator Dr. Albert Lecube told Reuters Health. "The first, and more obvious, is that all measures for achieving normoglycemia may help to improve treatment outcomes."

In the study, published in the October issue of the American Journal of Gastroenterology, Dr. Lecube of Hospital Vall d'Hebron, Barcelona and colleagues retrospectively compared 111 HCV patients who did not respond with 67 who had a sustained virological response (SVR) to treatment with interferon and ribavirin.

The SVR rate was 45.13% in normoglycemic patients, 28.25% in patients with impaired fasting glucose, and 15.78% in patients with type 2 diabetes.

Most (80%) of the patients had genotype 1 HCV, which was associated with failure to maintain an SVR (odds ratio, 1.55), as was the presence of glucose abnormalities (odds ratio, 2.33).

Comparison of 65 patients with glucose abnormalities and 65 controls matched for factors including age and liver fibrosis also showed a significantly lower SVR (24.6% versus 44.6%).

Measures that may improve SVR, Dr. Lecube suggested, range "from body weight loss with diet and exercise to the use of hypoglycemic agents -- oral treatment, insulin or both -- prior to and during antiviral treatment."

Am J Gastroenterol 2007;102:2189-2195.