Insulin resistance predicts rapid virological response in non-diabetic, non-cirrhotic genotype 1 HCV patients treated with peginterferon alpha-2b plus ribavirin: Some issues
Authors: Kuan-Ta Wu, Jeng-Fu Yang, Wan-Long Chuang, Ming-Lung Yu
Journal: Journal of Hepatology (2009)

Insulin resistance predicts rapid virological response in non-diabetic, non-cirrhotic genotype 1 HCV patients treated with peginterferon alpha-2b plus ribavirin: A clarificationJournal of HepatologyVol. 52Issue 2PreviewWe read with interest the comment by Wu and colleagues on our recently published paper [1]. Two issues indeed need to be clarified. Full-Text PDF Open Access We read with great interest the report by Grasso et al. in a recent issue of the Journal of Hepatology[[1]Grasso A. Malfatti F. Leo P.D. Martines H. Fabris P. Toscanini F. et al.Insulin resistance predicts rapid virological response in non-diabetic, non-cirrhotic genotype 1 HCV patients treated with peginterferon alpha-2b plus ribavirin.J Hepatol. 2009; 23: 23Google Scholar]. They enrolled 90 consecutive, non-diabetic, non-cirrhotic patients with genotype 1 chronic hepatitis C, treated with peginterferon alpha-2b plus ribavirin. Two issues need clarification. The first concerns the unit of sensitivity of the qualitative reverse-transcription PCR test, Roche Cobas Amplicor assay which was mistakenly written as copies per millilitre in this paper. It should be international units per millilitre [[2]Hsieh M.Y. Lee L.P. Hou N.J. Yang J.F. Huang J.F. Dai C.Y. et al.Qualitative application of COBAS AMPLICOR HCV test version 2.0 assays in patients with chronic hepatitis C virus infection and comparison of clinical performance with version 1.0.Kaohsiung J Med Sci. 2007; 23: 332-338Abstract Full Text PDF PubMed Scopus (6) Google Scholar]. Secondly, rapid virological response (RVR) [3Dai C.Y. Huang J.F. Hsieh M.Y. Hou N.J. Lin Z.Y. Chen S.C. et al.Insulin resistance predicts response to peginterferon-alpha/ribavirin combination therapy in chronic hepatitis C patients.J Hepatol. 2009; 50: 712-718Abstract Full Text Full Text PDF PubMed Scopus (131) Google Scholar, 4Romero-Gomez M. Del Mar Viloria M. Andrade R.J. Salmeron J. Diago M. Fernandez-Rodriguez C.M. et al.Insulin resistance impairs sustained response rate to peginterferon plus ribavirin in chronic hepatitis C patients.Gastroenterology. 2005; 128: 636-641Abstract Full Text Full Text PDF PubMed Scopus (671) Google Scholar] and homeostasis model assessment of insulin resistance (HOMA-IR) [5Yu M.L. Dai C.Y. Huang J.F. Chiu C.F. Yang Y.H. Hou N.J. et al.Rapid virological response and treatment duration for chronic hepatitis C genotype 1 patients: a randomized trial.Hepatology. 2008; 47: 1884-1893Crossref PubMed Scopus (257) Google Scholar, 6Yu M.L. Dai C.Y. Huang J.F. Hou N.J. Lee L.P. Hsieh M.Y. et al.A randomised study of peginterferon and ribavirin for 16 versus 24 weeks in patients with genotype 2 chronic hepatitis C.Gut. 2007; 56: 553-559Crossref PubMed Scopus (274) Google Scholar] have been important factors associated with achievement of a sustained virological response (SVR). However, the current study observed that HOMA-IR could predict rapid virological response (RVR) but not SVR [[1]Grasso A. Malfatti F. Leo P.D. Martines H. Fabris P. Toscanini F. et al.Insulin resistance predicts rapid virological response in non-diabetic, non-cirrhotic genotype 1 HCV patients treated with peginterferon alpha-2b plus ribavirin.J Hepatol. 2009; 23: 23Google Scholar]. There is low probability of normal distribution for HOMA-IR. For example, the mean value and standard deviation of HOMA-IR was 2.6 and 2.1, respectively, in the current study. Therefore, non-parametric inferential statistical methods or logarithmic transformation of original values to improve skewness before analyses are preferred in this situation.