Hepatitis C Clinical Trial
Official title:
Improving Treatment and Liver Fibrosis Outcomes With Metformin in HCV-HIV Co-infected and HCV Mono-infected Patients With Insulin Resistance.
This study will evaluate the role of Metformin on liver fibrosis in HCV-HIV co-infected and HCV mono-infected patients with insulin resistance receiving DAA HCV treatment.
HCV antiviral therapy has evolved rapidly in recent years and access to these medications has
improved. While SVR is associated with improved liver outcomes, the rate of liver fibrosis
regression with SVR is variable and predictors of regression are not well established. In
addition, achieving SVR in patients with cirrhosis does not necessarily prevent
decompensation or eliminate the risk of HCC. A better understanding of the role insulin
resistance and impaired glucose metabolism have on these outcomes in HCV patients who achieve
SVR are needed.
Identifying and targeting potentially modifiable risk factors such as IR may be of
significant importance in preventing progression of and promoting regression of liver
fibrosis, reducing mortality and improving outcomes for HCV-HIV co-infected and
HCV-mono-infected patients.
This proposed pilot study will be the first to evaluate the role of Metformin on liver
fibrosis in HCV-HIV co-infected and HCV mono-infected patients with IR receiving DAA HCV
treatment.
If Metformin is effective in reducing liver fibrosis in this patient population, this will
represent a well-tolerated, easy to administer, inexpensive therapy that will protect against
negative HCV outcomes. This study will also be an opportunity to evaluate the impact of
insulin resistance and hyperglycemia have on viral clearance HCV-infected patients treated
with interferon-free regimens. In addition, the study will further explore the relationship
between HCV, insulin resistance and AFP levels.
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