Effects of Metformin, Pegylated Interferon Alpha and Ribavirin for Chronic Hepatitis C With Insulin Resistance

Effects of Metformin, Pegylated Interferon Alpha and Ribavirin for Chronic Hepatitis C With Insulin Resistance

The aim of the study is to investigate the treatment response of metformin, Peg-IFN and ribavirin combination therapy for chronic hepatitis C virus (HCV).

Current standard of treatment for HCV with pegylated interferon(Peg-IFN)-alpha and ribavirin can achieve sustained virological response (SVR) in only 60-90% of patients. Insulin resistance is an important factor of non-response to combination therapy. Metformin is a insulin sensitizer and can effectively reduce insulin resistance. The aim of the study is to investigate the treatment response of metformin, Peg-IFN and ribavirin combination therapy for chronic HCV.

Inclusion Criteria:

• HCV RNA (+) and ALT > 40 U/L
• Compensated liver
• HOMA-IR > 2

Exclusion Criteria:

• neutrophil <1500/mm3
• male: Hb < 13 g/dl, female: Hb < 12 g/dl
• platelet < 80,000 /mm3
• Cr > 2.5 mg/dl
• Alcohol use > 20 gm per day
• uncontrolled depression, thyroid disease, autoimmune disease
• Pregnancy
• Hepatocellular carcinoma
• allergy to interferon or ribavirin
• Diabetes
• HBV/HIV co-infection