ABSTRACT
Obesity is a modifiable risk factor for nonresponse to chronic hepatitis C [CHC] treatment. We examined whether weight loss during pegylated interferon [IFN] plus Ribavirin therapy is associated with improved response. Rapid virological response, early virological response, end of treatment response, and sustained virological response [SVR] were compared among patients with or without weight loss [>/= 0.5 body mass index [BMI]] during therapy for hepatitis C virus. Among 324, who provided consent, 280 were treatment-naive patients and 200 started pegylated-IFN/Ribavirin therapy and were included in the study. Median pretreatment BMI was 28.8 +/- 5.7 [19.9-48.9] with 42.6% overweight and 31.6% obese [BMI 25-30 and >/= 30, respectively]. Hepatitis C virus genotype 1 was the prevalent genotype among the candidates of this study, affecting 99 cases of 136 [72.7%], whereas genotypes 2/3 affected 37 cases [27.3%]. For genotype 1, weight loss at 1 and 3 months was associated with higher SVR rates [59.5 vs. 36.8% at 1 month and 55.2 vs. 34.1% at 3 months, respectively, P values=0.02 and 0.03, respectively]. Hepatic fibrosis, elevation of high-density lipoprotein, and decline of homeostasis model of assessment-insulin resistance at 6-months follow-up were proven to be independent predictors for SVR. Weight loss during the first 6 months of IFN therapy was associated with improved SVR in patients with CHC genotype 1 rather than genotypes 2/3. Molecular changes associated with weight loss during CHC and its relation with treatment response need to be prospectively examined