Pegylated interferon plus ribavirin therapy improves pancreatic β-cell function in chronic hepatitis C patients

Background/Aims: Pretreatment insulin resistance (IR) is associated with treatment response to peginterferon plus ribavirin (PegIFN/RBV) combination therapy in chronic hepatitis C (CHC) infection. However, the impact of PegIFN/RBV therapy on both IR and β‐cell function in CHC patients has rarely been investigated. Methods: A total of 277 non‐diabetic patients treated with PegIFN‐α and weight‐based RBV, with 80/80/80 adherence, were recruited. Their IR and β‐cell function by homeostasis model assessment model (HOMA‐IR and HOMA‐%B) before treatment and at 24 week after treatment [end of follow‐up (EOF)] was measured. Results: A sustained virological response (SVR) was achieved by 79.4% (220/277) of all patients: 63.6% (75/118) of genotype‐1 and 91.2% (145/159) of genotype‐non‐1 patients. There was no significant change of HOMA‐IR post‐therapy (2.25 ± 2.46 vs 2.04 ± 2.12, P=0.42). By contrast, there was a significant reduction of HOMA‐%B of all patients at EOF (122.9 ± 145.2 vs 92.4 ± 73.2, P=0.001), particularly in those responders (119.1 ± 142.1 vs 89.6 ± 70.3, P=0.002). In 80 patients with high baseline HOMA‐IR, both HOMA‐IR and HOMA‐%B decreased significantly at EOF, irrespective of SVR achievement. Conclusion: This study demonstrated pancreatic β‐cell function was ameliorated by PegIFN/RBV therapy in CHC patients, particularly in those responders.