Review article: chronic hepatitis C--natural history and cofactors.
ABSTRACT Chronic hepatitis C is highly heterogeneous in clinical presentation and outcomes. This heterogeneity is largely related to host factors that have been clearly proven to affect the severity and rapidity of disease progression. The most relevant factors that have been shown to accelerate progression to cirrhosis include age at infection, alcohol abuse and the metabolic syndrome with insulin resistance, obesity and hepatic steatosis. Co-infection with HIV and/or HBV also increases the risk of progression to cirrhosis and to hepatocellular carcinoma. Surprisingly enough, viral related factors appear as less important and neither the virus genotype and load have been found to exert a clear influence on disease severity and progression, although more data in this field, and particularly on the role of different viral proteins in causing cytopathic effects, are awaited and may change this view in the near future.
Article: Association of hepatitis C virus with insulin resistance: evidences from animal studies and clinical studies.[show abstract] [hide abstract]
ABSTRACT: HCV infection is strongly associated with development of insulin resistance and type-2 diabetes, however molecular mechanism of these associations is not known. The aim of this review was to conduct a comprehensive literature search to understand the nature of the association between hepatitis C virus (HCV) infection and insulin resistance (IR). We also explored the role of HCV core protein and NS5a in modulating the course of the insulin-signaling pathway. EVIDENCE ACQUISITIONS: We searched Directory of Open Access Journals (DOAJ) Google Scholar, Pubmed (NLM), LISTA (EBSCO), Web of Science (TS and PakMediNet). Emerging evidence suggests an association between HCV infection and carotid/coronary vascular disease. IR appears to be a dominant underlying cause of accelerated atherosclerosis in patients with chronic hepatitis C (CHC). HCV can induce IR directly through the stimulation of SOCS3 and PPA2, and both of these molecules have been shown to inhibit interferon-α signaling. Improvement of insulin sensitivity may increase the response rate to antiviral treatment and prevent IR complications, including vascular diseases. The results of several clinical trials that have used insulin sensitizers (metformin and PPAR-γ agonists) have been inconclusive. Beside the association between HCV and IR, the published data also have showed the possible association of HCV core and NS5A protein with IR.Hepatitis Monthly 01/2012; 12(1):11-5. · 2.19 Impact Factor
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ABSTRACT: Reactive oxygen and nitrogen species play complex roles in the physiological regulation of cell metabolism and in many disease processes as well, including viral infections. Viral replication occurs within living cells and is totally dependent on its host's biosynthetic machinery. Many intracellular signaling pathways exploited by viruses for their own replication are regulated by the oxidoreductive (redox) state of the host cell. Consequently, factors that alter the balance between reactive oxygen/nitrogen species and antioxidant molecules/enzymes-including metabolic conditions like malnutrition, obesity, and diabetes-can influence cells' susceptibility to viral infection, the efficiency of viral replication, and as a result the progression and severity of virus-induced diseases. This review examines the ways in which the host-cell redox state affect viral replication and the actual potential of antioxidants to combat viral infections.Current pharmaceutical design 09/2011; 17(35):3898-904. · 4.41 Impact Factor
Article: Association of Hepatitis C Virus With Insulin Resistance: Evidences From Animal Studies and Clinical Studies.Hepatitis Monthly 03/2012; · 2.19 Impact Factor