Editorial
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World J Gastroenterol. Nov 7, 2013; 19(41): 6947-6956
Published online Nov 7, 2013. doi: 10.3748/wjg.v19.i41.6947
Are metabolic factors still important in the era of direct antiviral agents in patients with chronic hepatitis C?
Alessandro Grasso, Federica Malfatti, Roberto Testa
Alessandro Grasso, Federica Malfatti, Roberto Testa, Gastroenterology Unit, Department of Internal Medicine, San Paolo Hospital, 17100 Savona, Italy
Author contributions: Grasso A collected the data and wrote the manuscript; Malfatti F critically revised the manuscript and contributed to the manuscript writing; and Testa R supervised the manuscript; all authors approved the final version of the manuscript.
Correspondence to: Alessandro Grasso, MD, Gastroenterology Unit, Department of Internal Medicine, San Paolo Hospital, Via Genova 38, 17100 Savona, Italy. a.grasso@asl2.liguria.it
Telephone: +39-19-8404280 Fax: +39-19-8404364
Received: June 28, 2013
Revised: July 27, 2013
Accepted: August 16, 2013
Published online: November 7, 2013
Processing time: 141 Days and 10.8 Hours
Core Tip

Core tip: This editorial explores the past and present role of metabolic factors by analyzing the data that has emerged from the post hoc analysis of registrative trials of direct antiviral-based treatment. Low-density lipoprotein-cholesterol and statin use proved to be predictors of sustained viral response (SVR) in both boceprevir and telaprevir-treated patients, respectively. Furthermore, HOMA-IR negatively influenced SVR in prior partial and null responders treated with telaprevir-based schedules. By transferring these data to the real world scenario in which patients have comorbidities, advanced fibrosis and prior failure to antiviral treatment, we believe that metabolic factors might play a non-negligible role in influencing antiviral response, even in triple therapy.