{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T14:57:28Z","timestamp":1761663448889},"reference-count":0,"publisher":"Hindawi Limited","issue":"6","license":[{"start":{"date-parts":[[2012,1,1]],"date-time":"2012-01-01T00:00:00Z","timestamp":1325376000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Canadian Journal of Gastroenterology"],"published-print":{"date-parts":[[2012]]},"abstract":"<jats:p>BACKGROUND: Hepatitis C virus (HCV) infection may induce insulin resistance (IR) irrespective of the severity of liver disease, and there is evidence of a central role for IR in failure to achieve sustained virological response (SVR) in HCV patients.<\/jats:p><jats:p>OBJECTIVE: To assess IR as a predictor of the severity of hepatic fibrosis in Egyptian HCV patients, and its effect on early viral kinetics and virological response to HCV therapy.<\/jats:p><jats:p>METHODS: A total of 140 chronic HCV patients were divided into two groups according to the homeostasis model assessment-IR (HOMA-IR). Group 1 consisted of 48 chronic HCV patients with HOMA-IR \u22652, and group 2 consisted of 92 chronic HVC patients without IR (HOMA IR &lt;2). All patients were treated with combination therapy (pegylated interferon-alpha 2a plus ribavirin) for 48 weeks and studied for viral kinetics throughout the period of therapy.<\/jats:p><jats:p>RESULTS: The study revealed that older age, higher body mass index and HOMA-IR\u22652 were significantly associated with advanced fibrosis. Rapid virological response, complete early virological response and SVR were significantly lower in the IR-HCV group compared with the non-IR-HCV group. Univariate and multivariate analyses revealed that older age, fibrosis (F\u22653), high viral load (&gt;600,000 IU\/mL) and HOMA-IR \u22652 were significantly associated with a lack of viral kinetics as well as SVR. However, HOMA-IR \u22652 was the main independent variable associated with lack of SVR. On the other hand, body mass index, plasma insulin level and HOMA-IR decreased significantly compared with starting levels in patients who achieved SVR. This suggests a cause and effect relationship between HCV infection and IR.<\/jats:p><jats:p>CONCLUSION: IR in chronic HCV patients is associated with progressive fibrosis and slow viral kinetics, and could be a predictor for lack of rapid and early virological response. Therefore, HOMA-IR levels should be measured and improved before starting antiviral treatment.<\/jats:p>","DOI":"10.1155\/2012\/291457","type":"journal-article","created":{"date-parts":[[2016,3,15]],"date-time":"2016-03-15T07:53:12Z","timestamp":1458028392000},"page":"325-329","source":"Crossref","is-referenced-by-count":8,"title":["The Interaction among Insulin Resistance, Liver Fibrosis and Early Virological Response in Egyptian Patients with Chronic Hepatitis C"],"prefix":"10.1155","volume":"26","author":[{"given":"Dina H","family":"Ziada","sequence":"first","affiliation":[{"name":"Department of Tropical Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sherif","family":"El Saadany","sequence":"additional","affiliation":[{"name":"Department of Tropical Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Enaba","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Medhat","family":"Ghazy","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azza","family":"Hasan","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine, Tanta University, Tanta, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"98","container-title":["Canadian Journal of Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/cjgh\/2012\/291457.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cjgh\/2012\/291457.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2016,8,23]],"date-time":"2016-08-23T08:13:58Z","timestamp":1471940038000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.hindawi.com\/journals\/cjgh\/2012\/291457\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012]]},"references-count":0,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2012]]}},"alternative-id":["291457"],"URL":"https:\/\/doi.org\/10.1155\/2012\/291457","relation":{},"ISSN":["0835-7900"],"issn-type":[{"value":"0835-7900","type":"print"}],"subject":[],"published":{"date-parts":[[2012]]}}}