Background: HCV has been identified as the cause of metabolic syndrome, a complex that includes dyslipidemia, diabetes and insulin resistance (IR). Insulin Resistance (IR) index, is a negative predictor of response to interferon-based therapies in patients with HCV. IL28B variations are strongly associated with on-treatment viral kinetics and approximately 2-fold increased sustained virologic response (SVR) rates in HCV genotype 1 and 4 patients, so IL28B gene polymorphism is also considered as a good predictor of treatment response. Aim: To determine the correlation between interleukin 28B genotype and insulin resistance in patients with chronic hepatitis C virus genotype 4 and response to Pegylated interferon and ribavirin treatment. Methods: The study included HCV Patients (n=50) and control patients (n=50). IR was estimated using Homeostasis model assessment (HOMA-IR) = (Serum Insulin (IU/ml)*Serum Glucose (mmol/L) /22.5), viral load was determined by real-time PCR, also SNP assay was done using IL28B polymorphism real time. Results: IL-28 rs12799860 genotypes in HCV patients were as follows; CC genotypes in 58 % (n = 29), CT in 36 % (n = 18) and TT in 6 % (n = 3). The response rate was 86.2 % in CC genotype versus 27.8 % in CT genotype and 2% in TT genotypes which was statistically significant (P=0.001). The correlation between HOMA and response among cases was significantly negative. HOMA-IR >2 was associated with poorer SVR response (39.3% vs. 58.7%; P = 0.007). Conclusion: Results show that IL28B and IR are independent variables associated with SVR for P+R treated patients.
Keywords:IL28B, HOMA, HCV, Gene, Polymorphism, Insulin resistance, Ribavirin, Therapy.