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June 22, 2006

Overweight people have poor response to hepatitis C treatment

New research suggests that obese patients in treatment for chronic hepatitis C infection are more likely to achieve better results if the abnormalities associated with excessive fat tissue are corrected first. Obesity is considered a metabolic condition, not merely a matter of being very overweight, according to lead author Michael R. Charlton of the Mayo Clinic and colleagues. In HCV-infected patients, obesity is associated with inflammation and insulin resistance, a prediabetic abnormality of blood sugar. Obese HCV patients may also have steatosis, fatty liver disease; liver scarring; fibrosis progression; and poor response to standard HCV treatments interferon and ribavirin. In addition, HCV patients with obesity-related fatty liver disease are at increased risk for more advanced liver disease. The investigators identified weight loss to reduce fat tissue as a key step to improving response to treatment. Treatment with diabetes drugs like metformin and pioglitazone to raise insulin sensitivity and reduce fat accumulation in the liver might help reverse disease progression, according to the report. Administering higher doses of combination drug therapy for an extended period of time could help offset the decreased drug response. Doses could be determined by body mass index instead of weight, the team wrote. “Treatment strategies that focus on improving underlying metabolic factors associated with poor response to combination therapy are more likely to overcome the low sustained viral response rates observed in obese patients infected with HCV,” the researchers concluded. (Reuters)

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