THE STUDY OF THE MECHANISMS WHICH INDUCE A LOW RESPONSE TO THE ANTIVIRAL THERAPY IN OBESE PATIENTS WITH INSULIN RESISTANCE IN CHRONIC VIRAL HEPATITIS C

Abstract

Taking into consideration the fact that chronic hepatitis C (CHC) is associated with a high risk of developing hepatic cirrhosis and hepatocellular carcinoma, the success of the treatment of this infection is extremely important. In patients with CHC it was observed an increased obesity rate and insulin resistance (IR) and a diminution of sustained virologic response (SVR) to the treatment with Peginterferon (PegIFN) and Ribavirine. The researches have shown that IR interferes with the antiviral therapy, being an important predictor for a low SVR in CHC patients treated with PegIFN and Ribavirine. PegIFN can interfere with insulin path and inflammation mechanisms. Obesity modifies the secretor adipocytokines profile and determines inflammatory reaction and IR, reducing thus the SVR. Adipokines reduce SVR in obese patients with CHC, directly or through suppressor of cytokine signaling 3 (SOCS3). There was studied the polymorphisms (SNPs) of SOCS3 in non-responsive patients and in patients with SVR. Taking into consideration the relationship obesity - IR – SVR rate diminution, it is very important to identify the possibilities to reduce weight, to maintain ideal weight on the long term, to reduce IR, to modify adipocytokines level, with consecutive benefits for SVR.