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Hepatitis C and insulin resistance: mutual interactions. A review
S Decock1, C Verslype, J Fevery
1Gastro-enterology/Hepatology, University Hospital Leuven, Herestraat 49, 3000 Leuven. Sofie.Decock@uz.kuleuven.be
Acta Clinica Belgica
|June 6, 2007
Summary
Hepatitis C virus (HCV) infection directly causes insulin resistance and type 2 diabetes, independent of liver cirrhosis. HCV core protein disrupts metabolic pathways, increasing diabetes risk and predicting poorer treatment response.
Area of Science:
- Hepatology
- Endocrinology
- Virology
Background:
- Chronic hepatitis C virus (HCV) infection affects 200 million globally, leading to liver cirrhosis and transplantation.
- HCV infection is linked to clinical issues like type 2 diabetes, with higher prevalence than in HBV cirrhosis.
- While cirrhosis can cause insulin resistance, the elevated diabetes rates in HCV suggest a direct viral role.
Purpose of the Study:
- To investigate the direct mechanisms by which HCV infection contributes to insulin resistance and type 2 diabetes.
- To explore the role of HCV core protein in metabolic dysregulation.
- To assess the predictive value of insulin resistance for antiviral therapy response in chronic hepatitis C.
Main Methods:
- Analysis of HCV core protein's effects on hepatic steatosis via microsomal triglyceride transfer protein inhibition.
- Investigation of HCV core protein's impact on insulin signaling pathways, including TNF-alfa.
- Correlation of insulin resistance with treatment outcomes in patients receiving peginterferon plus ribavirin.
Main Results:
- HCV core protein induces hepatic steatosis, a known cause of insulin resistance.
- HCV core protein directly impairs insulin signaling pathways, contributing to insulin resistance.
- Insulin resistance is a significant predictor of suboptimal response to standard antiviral therapy for chronic hepatitis C.
Conclusions:
- HCV infection independently contributes to insulin resistance and type 2 diabetes, beyond the effects of cirrhosis.
- HCV core protein plays a key role in developing insulin resistance through metabolic disruption.
- Managing insulin resistance is crucial for improving treatment efficacy in chronic hepatitis C patients.
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