Insulin resistance and HCV virologic response to peg-interferons (Peg-IFN) with ribavirin (RBV) in HIV/HCV co-infected patients

Background/Aims:To evaluate the possible influence of baseline insulin resistance in sustained virological response. Methods:One hundred and fifty-five consecutive individuals from a multicentric cohort of HIV/ HCV co-infected patients who underwent therapy with pegylated interferon plus ribavirin were included. The main outcome variable was sustained virological response, defined as undetectable plasma HCV RNA at week 24 after the end of the therapy. Insulin resistance was determined using the HOMA method. Results: Sustained virological response was achieved in 55 (36%) patients. Forty-two (38%) patients with aHOMA lower than 4 developed sustained virological response vs 13 (29%) of those with a HOMA above 4 (p = 0.27). Analyses restricted to patients harbouring genotype 1 or 4 showed similar rates of sustained virological response among patients with aHOMA below and above 4 [19 (27%) vs 7 (24%); p = 0.8]. In the multivariate analysis, genotype 3 [AOR 9.26; 95%CI 3.03 28.30; p < 0.0001], a baseline HCV viral load below 600.000 IU/mL [AOR 2.97; 95% CI 1.03 8.57; p = 0.04] and baseline LDL cholesterol above 100 mg/dL [AOR 6.62; 95% CI 1.97 22.19; p = 0.002] were independently associated with sustained virological response. Conclusions: Insulin resistance is not a relevant predictor of sustained virological response to pegylated interferon plus ribavirin in HIV/HCV co-infected patien