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Metabolic syndrome is associated with poor treatment response to antiviral therapy in chronic hepatitis C genotype 3 patients

Aziz, Hafsaa; Gill, Uzmab; Raza, Abidaa; Gill, Muzaffar L.b

European Journal of Gastroenterology & Hepatology: May 2014 - Volume 26 - Issue 5 - p 538–543
doi: 10.1097/MEG.0000000000000078
Original Articles: Hepatitis

Introduction Hepatitis C viral (HCV) infection is caused by an RNA virus. HCV infection is considered to induce systemic disease that causes steatosis, alters lipid metabolism, and results in metabolic syndrome. This study aimed to investigate the therapeutic outcome in HCV genotype 3 patients with metabolic syndrome.

Materials and methods A total of 621 HCV-positive patients who visited the hospital for treatment were screened. Among these, 441 patients were enrolled for antiviral therapy. These enrolled patients were assessed for metabolic syndrome according to the International Diabetes Federation criteria. Group A included patients with metabolic syndrome and group B included patients without metabolic syndrome. All patients received peginterferon-α2a (180 μg/week) and ribavirin (10 mg/kg/day) for 6 months.

Results The prevalence of metabolic syndrome in chronic HCV patients was 37.9%. We observed that metabolic syndrome was more common among female compared with male participants (43.9 vs. 28.8%, P=0.005). It was found that sustained virologic response (SVR) rates were significantly higher in the patients in group B (without metabolic syndrome) compared with the patients in group A who had metabolic syndrome (72.2 vs. 43.7%, P<0.05). Older patients were at a higher risk for metabolic syndrome and a correlation of metabolic syndrome with nonresponse to antiviral therapy was observed. An interesting correlation among metabolic syndrome, age, and SVR was found: with age, SVR decreases, while metabolic syndrome increases.

Conclusion Metabolic syndrome has an influence on therapeutic outcomes in terms of SVR. Moreover, this information can identify patients who might have a low chance of attaining an SVR and a timely decision may protect the patients from the adverse effects of therapy.

aNuclear Medicine, Oncology and Radiotherapy Institute

bMaroof International Hospital, Islamabad, Pakistan

Correspondence to Uzma Gill, MD, Maroof International Hospital, Islamabad 44000, Pakistan Tel: +92 300 855 0101; fax: +92 51 222 2939; e-mail:

Received July 19, 2013

Accepted February 7, 2014

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins