Clinical parallels and experience of antivira l therapy in chronic hepatitis with polycystic ovary syndrome

Abstract

Background. Despite the progress made in the treatment of chronic hepatitis C (CHC), there remain many unsolved problems in the treatment of patients infected with the 3rd virus genotype. This fact is mainly associated with the presence of hepatocyte steatosis due to the formation of local insulin resistance. Another important medical and social problem is polycystic ovary syndrome (PCOS), patogenetically associated with insulin resistance. Application of metformin in females to reduce insulin resistance can improve the results of antiviral therapy.Material and methods. Overall 81 females with CHC and PCOS were included in original study. The 1st group (35 patients) received metformin in dose of 20 mg/kg of body weight per day as preliminary and concomitant treatment in addition to antiviral therapy. In 14 patients of this group steatosis was revealed. In another subgroup (21 patients) steatosis was not revealed. The 2nd group (46 patients) received antiviral therapy only. Patients of this group were divided into two subgroups by presence (17 patients) or absence (29 patients) of hepatic steatosis. Interferon-α2b in a standard dose of 3 million IU3 times per week in combination to ribavirin 13 mg/kg/day for 24 wks was applied as antiviral therapy. The period of the subsequent follow-up was 24 wks.Results. Patients with hepatic steatosis had higher biochemical and histological scores of activities. In the groups of patients receiving metformin a higher incidence of a sustained virological response was observed. Additional application of metformin did not aff ect the safety profile of antiviral therapy.Conclusions. Women with CHC with the 3rd genotype and PCOS, who took metformin, had a significantly higher frequency of sustained virological response with an equal safety profile.