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Influence of insulin resistance on hepatic fibrosis and steatosis in hepatitis C virus (HCV) mono-infected compared with HIV-HCV co-infected patients.
Aliment Pharmacol Ther 2009; 30(1):61-70AP

Abstract

BACKGROUND

Insulin resistance (IR), the major feature of the metabolic syndrome, is also common in patients with chronic HCV infection. Liver fibrosis and steatosis are known potential outcome of chronic hepatitis B or C infection. Studies have shown that HIV positive individuals co-infected with HCV have more rapid live disease progression than those with HIV alone. Few data have reported the influence of IR on steatosis and fibrosis in the context of HIV-HCV coinfection.

AIM

To test the association among insulin resistance (IR), liver fibrosis and liver steatosis in HIV-HCV and HCV-infected patients.

PATIENTS AND METHODS

A total of 170 HIV-HCV-infected patients matched by age, gender and genotype with 170 HCV mono-infected patients were included. Patients were considered to be IR when the homeostasis model assessment of IR >2. Significant fibrosis was considered if METAVIR >or=F2 and significant steatosis if >or=10%.

RESULTS

Insulin resistance was independently associated in HCV patients with fibrosis [odds ratio (OR) = 2.04 (95% CI 1.02-4)], a body mass index (BMI) >25 kg/m(2) [OR = 3.33 (1.47-7.69)] and steatosis [OR = 3.33 (1.67-6.67)]. Fibrosis >or=F2 was associated in HCV patients with high liver activity grade (>or=A2) [OR = 8.33 (3.85-16.67)], male gender [OR = 3.03 (1.33-7.14)] and IR [OR = 2.44 (1.15-5)]. In HIV-HCV patients, >or=A2 [OR = 5.56 (1.64-20)] was associated with fibrosis. Steatosis >or=10% was associated in HCV patients with IR [OR = 3.13 (1.59-6.25) and >or=F2 (OR = 2.22 (1.15-4.17)]. In HIV-HCV, a BMI >25 kg/m(2) [OR = 3.85 (1.64-9.10)], >or=A2 [OR = 2.16 (1.02-4.55); P = 0.044] and nucleoside reverse transcriptase inhibitor [OR = 3.61 (1.19-10.96); P = 0.023] were independently associated with significant liver steatosis.

CONCLUSIONS

Insulin resistance is associated with liver fibrosis and steatosis in HCV mono-infected, but not in HIV-HCV co-infected patients. Significant liver fibrosis is associated with IR independent of liver steatosis only in HCV mono-infected patients.

Authors+Show Affiliations

Laboratoire Alphabio, Marseille, France. philippe.halfon@alphabio.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19292832

Citation

Halfon, P, et al. "Influence of Insulin Resistance On Hepatic Fibrosis and Steatosis in Hepatitis C Virus (HCV) Mono-infected Compared With HIV-HCV Co-infected Patients." Alimentary Pharmacology & Therapeutics, vol. 30, no. 1, 2009, pp. 61-70.
Halfon P, Pénaranda G, Carrat F, et al. Influence of insulin resistance on hepatic fibrosis and steatosis in hepatitis C virus (HCV) mono-infected compared with HIV-HCV co-infected patients. Aliment Pharmacol Ther. 2009;30(1):61-70.
Halfon, P., Pénaranda, G., Carrat, F., Bedossa, P., Bourlière, M., Ouzan, D., ... Cacoub, P. (2009). Influence of insulin resistance on hepatic fibrosis and steatosis in hepatitis C virus (HCV) mono-infected compared with HIV-HCV co-infected patients. Alimentary Pharmacology & Therapeutics, 30(1), pp. 61-70. doi:10.1111/j.1365-2036.2009.03995.x.
Halfon P, et al. Influence of Insulin Resistance On Hepatic Fibrosis and Steatosis in Hepatitis C Virus (HCV) Mono-infected Compared With HIV-HCV Co-infected Patients. Aliment Pharmacol Ther. 2009;30(1):61-70. PubMed PMID: 19292832.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influence of insulin resistance on hepatic fibrosis and steatosis in hepatitis C virus (HCV) mono-infected compared with HIV-HCV co-infected patients. AU - Halfon,P, AU - Pénaranda,G, AU - Carrat,F, AU - Bedossa,P, AU - Bourlière,M, AU - Ouzan,D, AU - Renou,C, AU - Tran,A, AU - Rosenthal,E, AU - Wartelle,C, AU - Delasalle,P, AU - Cacoub,P, Y1 - 2009/03/09/ PY - 2009/3/19/entrez PY - 2009/3/19/pubmed PY - 2010/2/23/medline SP - 61 EP - 70 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 30 IS - 1 N2 - BACKGROUND: Insulin resistance (IR), the major feature of the metabolic syndrome, is also common in patients with chronic HCV infection. Liver fibrosis and steatosis are known potential outcome of chronic hepatitis B or C infection. Studies have shown that HIV positive individuals co-infected with HCV have more rapid live disease progression than those with HIV alone. Few data have reported the influence of IR on steatosis and fibrosis in the context of HIV-HCV coinfection. AIM: To test the association among insulin resistance (IR), liver fibrosis and liver steatosis in HIV-HCV and HCV-infected patients. PATIENTS AND METHODS: A total of 170 HIV-HCV-infected patients matched by age, gender and genotype with 170 HCV mono-infected patients were included. Patients were considered to be IR when the homeostasis model assessment of IR >2. Significant fibrosis was considered if METAVIR >or=F2 and significant steatosis if >or=10%. RESULTS: Insulin resistance was independently associated in HCV patients with fibrosis [odds ratio (OR) = 2.04 (95% CI 1.02-4)], a body mass index (BMI) >25 kg/m(2) [OR = 3.33 (1.47-7.69)] and steatosis [OR = 3.33 (1.67-6.67)]. Fibrosis >or=F2 was associated in HCV patients with high liver activity grade (>or=A2) [OR = 8.33 (3.85-16.67)], male gender [OR = 3.03 (1.33-7.14)] and IR [OR = 2.44 (1.15-5)]. In HIV-HCV patients, >or=A2 [OR = 5.56 (1.64-20)] was associated with fibrosis. Steatosis >or=10% was associated in HCV patients with IR [OR = 3.13 (1.59-6.25) and >or=F2 (OR = 2.22 (1.15-4.17)]. In HIV-HCV, a BMI >25 kg/m(2) [OR = 3.85 (1.64-9.10)], >or=A2 [OR = 2.16 (1.02-4.55); P = 0.044] and nucleoside reverse transcriptase inhibitor [OR = 3.61 (1.19-10.96); P = 0.023] were independently associated with significant liver steatosis. CONCLUSIONS: Insulin resistance is associated with liver fibrosis and steatosis in HCV mono-infected, but not in HIV-HCV co-infected patients. Significant liver fibrosis is associated with IR independent of liver steatosis only in HCV mono-infected patients. SN - 1365-2036 UR - https://www.unboundmedicine.com/medline/citation/19292832/Influence_of_insulin_resistance_on_hepatic_fibrosis_and_steatosis_in_hepatitis_C_virus__HCV__mono_infected_compared_with_HIV_HCV_co_infected_patients_ L2 - https://doi.org/10.1111/j.1365-2036.2009.03995.x DB - PRIME DP - Unbound Medicine ER -