Editorial
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Sep 21, 2009; 15(35): 4356-4364
Published online Sep 21, 2009. doi: 10.3748/wjg.15.4356
Molecular mechanisms of insulin resistance in chronic hepatitis C
Mark W Douglas, Jacob George
Mark W Douglas, Jacob George, Storr Liver Unit, Westmead Millennium Institute, University of Sydney at Westmead Hospital, PO Box 412, Westmead, NSW 2145, Australia
Author contributions: Douglas MW and George J wrote this paper.
Supported by Australian National Health and Medical Research Council and the Robert W Storr Bequest to the University of Sydney
Correspondence to: Dr. Mark W Douglas, MD, PhD, Storr Liver Unit, Westmead Millennium Institute, University of Sydney at Westmead Hospital, PO Box 412, Westmead, NSW 2145, Australia. mark.douglas@usyd.edu.au
Telephone: +61-2-98457705 Fax: +61-2-96357582
Received: July 2, 2009
Revised: August 13, 2009
Accepted: August 20, 2009
Published online: September 21, 2009
Abstract

It is now widely recognized that chronic hepatitis C (CHC) is associated with insulin resistance (IR) and type 2 diabetes, so can be considered a metabolic disease. IR is most strongly associated with hepatitis C virus (HCV) genotype 1, in contrast to hepatic steatosis, which is associated with genotype 3 infection. Apart from the well-described complications of diabetes, IR in CHC predicts faster progression to fibrosis and cirrhosis that may culminate in liver failure and hepatocellular carcinoma. More recently, it has been recognized that IR in CHC predicts a poor response to antiviral therapy. The molecular mechanisms for the association between IR and HCV infection are not well defined. This review will elaborate on the clinical associations between CHC and IR and summarize current knowledge regarding the molecular mechanisms that potentially mediate HCV-associated IR.

Keywords: Hepatitis C virus, Insulin resistance, Treatment response, Interferon