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<PubmedArticle><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">22044490</PMID><DateCompleted><Year>2012</Year><Month>02</Month><Day>22</Day></DateCompleted><DateRevised><Year>2021</Year><Month>10</Month><Day>20</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1743-422X</ISSN><JournalIssue CitedMedium="Internet"><Volume>8</Volume><PubDate><Year>2011</Year><Month>Nov</Month><Day>01</Day></PubDate></JournalIssue><Title>Virology journal</Title><ISOAbbreviation>Virol J</ISOAbbreviation></Journal><ArticleTitle>Chronic hepatitis c genotype-4 infection: role of insulin resistance in hepatocellular carcinoma.</ArticleTitle><Pagination><StartPage>496</StartPage><MedlinePgn>496</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/1743-422X-8-496</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Hepatitis C virus (HCV) is a major cause of chronic hepatitis and hepatocellular carcinoma (HCC) and different HCV genotypes show characteristic variations in their pathological properties. Insulin resistance (IR) occurs early in HCV infection and may synergize with viral hepatitis in HCC development. Egypt has the highest reported rates of HCV infection (predominantly genotype 4) in the world; this study investigated effects of HCV genotype-4 (HCV-4) on prevalence of insulin resistance in chronic hepatitis C (CHC) and HCC in Egyptian patients.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Fifty CHC patients, 50 HCC patients and 20 normal subjects were studied. IR was estimated using HOMA-IR index and HCV-4 load determined using real-time polymerase chain reaction. Hepatitis B virus was excluded by enzyme-linked immunosorbent assay. Standard laboratory and histopathological investigations were undertaken to characterize liver function and for grading and staging of CHC; HCC staging was undertaken using intraoperative samples.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">HCC patients showed higher IR frequency but without significant difference from CHC (52% vs 40%, p = 0.23). Multivariate logistic regression analysis showed HOMA-IR index and International Normalization Ratio independently associated with fibrosis in CHC; in HCC, HbA1c, cholesterol and bilirubin were independently associated with fibrosis. Fasting insulin and cholesterol levels were independently associated with obesity in both CHC and HCC groups. Moderate and high viral load was associated with high HOMA-IR in CHC and HCC (p &lt; 0.001).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">IR is induced by HCV-4 irrespective of severity of liver disease. IR starts early in infection and facilitates progression of hepatic fibrosis and HCC development.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Mohamed</LastName><ForeName>Amal A</ForeName><Initials>AA</Initials><AffiliationInfo><Affiliation>Biochemistry Department, National Hepatology and Tropical Medicine Institute, Cairo 11796, Egypt. amalahmedhcp@yahoo.com</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Loutfy</LastName><ForeName>Samah A</ForeName><Initials>SA</Initials></Author><Author ValidYN="Y"><LastName>Craik</LastName><ForeName>James D</ForeName><Initials>JD</Initials></Author><Author ValidYN="Y"><LastName>Hashem</LastName><ForeName>Abdel Gawad M</ForeName><Initials>AG</Initials></Author><Author ValidYN="Y"><LastName>Siam</LastName><ForeName>Ibrahem</ForeName><Initials>I</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2011</Year><Month>11</Month><Day>01</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Virol J</MedlineTA><NlmUniqueID>101231645</NlmUniqueID><ISSNLinking>1743-422X</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006528" MajorTopicYN="N">Carcinoma, Hepatocellular</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000821" MajorTopicYN="Y">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004534" MajorTopicYN="N" Type="Geographic">Egypt</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004797" MajorTopicYN="N">Enzyme-Linked Immunosorbent Assay</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005838" MajorTopicYN="N">Genotype</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016174" MajorTopicYN="N">Hepacivirus</DescriptorName><QualifierName UI="Q000145" MajorTopicYN="Y">classification</QualifierName><QualifierName UI="Q000235" MajorTopicYN="Y">genetics</QualifierName><QualifierName UI="Q000302" MajorTopicYN="N">isolation &amp; purification</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D019698" MajorTopicYN="N">Hepatitis C, Chronic</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006651" MajorTopicYN="N">Histocytochemistry</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007333" MajorTopicYN="Y">Insulin Resistance</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008111" MajorTopicYN="N">Liver Function Tests</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015995" MajorTopicYN="N">Prevalence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D060888" MajorTopicYN="N">Real-Time Polymerase Chain Reaction</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012720" MajorTopicYN="N">Severity of Illness Index</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019562" MajorTopicYN="N">Viral Load</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2011</Year><Month>7</Month><Day>6</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2011</Year><Month>11</Month><Day>1</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2011</Year><Month>11</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2011</Year><Month>11</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2012</Year><Month>2</Month><Day>23</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pmc-release"><Year>2011</Year><Month>11</Month><Day>1</Day></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">22044490</ArticleId><ArticleId IdType="pmc">PMC3218090</ArticleId><ArticleId IdType="doi">10.1186/1743-422X-8-496</ArticleId><ArticleId IdType="pii">1743-422X-8-496</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>Lauer GM, Walker BD. 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