Division of Hepatogastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Expert Rev Anti Infect Ther. 2011 May;9(5):525-33. doi: 10.1586/eri.11.33.
It is now widely recognized that chronic hepatitis C is a metabolic disease, strongly associated with Type 2 diabetic mellitus and insulin resistance (IR). Chronic hepatitis C virus (HCV) infection promotes IR mainly through interfering with the insulin signaling pathway in hepatocytes, increasing the inflammatory response with production of cytokines such as TNF-α and IL-6, and increasing oxidative stress. Accumulated evidence indicates that HCV-associated IR may lead to fibrosis progression, resistance to antiviral therapy, hepatocarcinogenesis and extrahepatic manifestations. Thus, HCV-associated IR is a therapeutic target at any stage of HCV infection. However, specific pharmaceutical treatments of IR are still being evaluated in clinical trials, but available data do not warrant their use in all chronic hepatitis C patients with IR.
现在人们普遍认识到，慢性丙型肝炎是一种代谢性疾病，与 2 型糖尿病和胰岛素抵抗（IR）密切相关。慢性丙型肝炎病毒（HCV）感染主要通过干扰肝细胞中的胰岛素信号通路、增加 TNF-α 和 IL-6 等细胞因子的炎症反应以及增加氧化应激来促进 IR。越来越多的证据表明，HCV 相关的 IR 可能导致纤维化进展、抗病毒治疗耐药、肝癌发生和肝外表现。因此，HCV 相关的 IR 是 HCV 感染任何阶段的治疗靶点。然而，针对 IR 的特定药物治疗仍在临床试验中进行评估，但现有数据并不支持在所有伴有 IR 的慢性丙型肝炎患者中使用这些药物。
