Interferon-alpha improves glucose tolerance in diabetic and non-diabetic patients with HCV-induced liver disease

This pilot study was initiated to evaluate factors controlling glucose tole rance in patients with hepatitis C virus-induced liver disease before and a fter therapy with recombinant interferon-alpha (r-INF-alpha). Fifteen patie nts with histologically and serologically proven hepatitis C infection unde rwent oral and frequently sampled intravenous glucose tolerance tests (FSIG TT) before and after four months of therapy (6 x 10(6) U r-INF-alpha, subcu taneously, three times a week). Glucose, insulin and C-peptide data from FS IGTT were analysed using the minimal modeling technique to determine insuli n sensitivity, glucose effectiveness and first and second phase insulin sec retion. According to the WHO criteria 13 patients, had normal glucose toler ance; diabetes mellitus was diagnosed in 2 patients. In the morning followi ng the last r-INF-alpha injection four months later, insulin sensitivity im proved significantly in hepatitis C virus-infected patients with normal glu cose tolerance (2.17 +/- 0.37 vs. 6.18 +/- 0.94 10(-4) min(-1) per mu U/ml, p < 0.001) and with diabetes mellitus (0.86 to 2.61; 0.46 to 1.06 10(-4) m in(-1) per mu U/ml). This effect was independent of the extent of fibrosis, virus load before treatment and therapy response. First phase insulin secr etion increased in non-diabetic (139.2 +/- 17.1 vs. 200.0 +/- 32.7, p < 0.0 5) and diabetic patients with HCV infection (55.24 to 118.5; 84.23 to 261.1 ). Moreover, free fatty acid concentrations in all HCV-infected patients we re significantly reduced (0.48 +/- 0.01 vs 0.21 +/- 0.03 mmol/l, p < 0.01). Therapy with recombinant interferon-a is associated with an amelioration of glucose tolerance in non-diabetic and diabetic HCV-infected patients.