Metabolic factors involved in the therapeutic response of patients with hepatitis C virus‐related chronic hepatitis

Abstract Background: The purpose of the present paper was to investigate the factors possibly involved in the failure of pegylated interferon (Peg IFN) plus ribavirin treatment at standard dosage in hepatitis C virus (HCV) 1b patients, with chronic hepatitis. Methods: A fully screened population of 40 virological non‐responders (NR) to combined antiviral therapy was selected and matched, 1:1, with a similar cohort of end‐therapy virological responders (R). Results: Waist circumference, glucose metabolic impairment, body mass index, non‐genetic iron overload, steatosis and fibrosis severity and, finally, arterial hypertension were statistically more frequent in the NR group on Peg IFN plus ribavirin. Increased waist circumference was the strong independent predictor of therapeutical failure. Interestingly, the concomitant presence of cofactors was more significantly represented in NR, whereas in the R cohort this association was found in a few cases only. Conclusion: Insulin‐resistance syndrome could contribute to non‐response in treated chronic HCV patients, suggesting the presence of dysmetabolic factors that frequently cluster in a critical combination.