RUDN Journal of Medicine (Jun 2011)
With chronic hepatitis C and insulin resistance, treated with PEG-Interferon-α 2b and ribavirin effect of metformin on sustained virological response in patients
Abstract
Chronic virus lesions of a liver are one of the principal causes of a growing mortality in the Russian Federation and other countries from a cirrhosis and a hepatocellular carcinoma. At the present day one of the most significant prognostic factors of decreasing efficacy of therapy HCV-infection is insulin resistance (IR). 114 patients, who were treated with Peginterferonα-2b plus Ribavirin within 2008-2010 yrs., were prospectively studied. Patients with IR, but with the normal carbohydrate metabolism (n = 59) have been divided into 2 groups: the 1st group (n = 22) was prescribed combination of Peginterferonα-2b (1,5 mcg/kg per week) and Ribavirin (15 mg/kg per day) + Metformin (20 mg/kg/per day), with their informed consent, the 2nd group (control) - Peginterferonα-2b (1,5 mcg/kg per week) plus Ribavirin (15 mg/kg per day) (n = 37). Thus, IR is specific feature of HCV, irrespective of presence or absence of adiposity. IR is revealed in 37% of patients with normal body weight. Besides the improvement of way of life, diet observance, medical correction of IR in patients on interferon therapy is necessary. Correction of IR by Metformin is reasonable, beginning from value of HOMA-IR ≥ 2, at any genotype HCV, and considerably improves results of Peginterferon α-2b plus Ribavirin therapy, especially in patients with low or normal body weight. Metformin as the third component of Peginterferon α-2b plus Ribavirin therapy is safe and effective. Medical correction of IR is a new aim in treatment of hepatitis C.
