Animals were anesthetized by inhalation of isoflurane (2% v/v; Butler Schein, OH).

After laparotomy, the 70% hepatectomy involved surgical resection of the left and median liver lobes. Briefly, the connective tissue below the skin is dissected around the xyphoid process to access the abdominal cavity. Two incisions are then made parallel I-BET-762 chemical structure to the diaphragm to the left and right of the xyphoid process so as to expose the liver. Sterile 2-0 silk ligatures are then used to isolate both lobes simultaneously as close as possible to the inferior vena cava. The tissue is then resected distal to the ligature. The animals are closed with 5-0 silk, uninterrupted for the muscle and interrupted for the skin. Animals are administered bupranex (0.3 mg/kg in 3 mL NaCl, subcutaneously, Butler Schein, NY) and allowed to recover before returning to their cages. For the 85% PHTx, the surgery is identical to 70% with the addition of the right lower and caudate lobes. Liver specimens and blood samples were harvested at the indicated times before or after surgery and liver weights were also measured to calculate liver/body

weight ratios. For additional detailed methods, please refer to the Maraviroc research buy Supporting Material. HO-1 is an accepted homeostatic and cytoprotective gene and when induced confers potent protection. To test the role of HO-1 in liver regeneration, we performed a 70% PHTx in wildtype (wt) and hmox−/− mice. Although wt mice all survived the surgery and resection, all hmox-1−/− mice died within the first 24-36

hours, which we believe is likely due, in large part, to surviving the surgical procedure and overall stress on the animal (Fig. 1A). We therefore moved away from using the hmox-1−/− mice and elected to use a pharmacological approach in wt mice using the well-characterized selective inhibitor of HO-1, tin protoporphyrin (Sn-PP). Administration of Sn-PP also resulted in increased mortality versus vehicle and wt controls, but was delayed over a longer period of time spanning 2-4 days when compared to the rapid mortality in the hmox-1 nulls, MCE公司 which we concluded was more related in part to poor liver regeneration (Fig. 1A). To assess the effects of Sn-PP on hepatocyte proliferation, we performed immunohistochemical staining of liver biopsies from hepatectomized animals with and without Sn-PP to assess basic architectural changes as well as to evaluate proliferating cell populations. Liver sections were stained with hematoxylin and eosin (H&E) or Ki67, a marker of proliferating cells, 48 hours after partial hepatectomy in the presence and absence of Sn-PP. We observed disrupted architecture, inflammatory infiltrates, and hemorrhage in the Sn-PP-treated mice that was minimal or absent in controls (H&E, Fig. 1B).

Animals were anesthetized by inhalation of isoflurane (2% v/v; Butler Schein, OH).

After laparotomy, the 70% hepatectomy involved surgical resection of the left and median liver lobes. Briefly, the connective tissue below the skin is dissected around the xyphoid process to access the abdominal cavity. Two incisions are then made parallel PF-02341066 price to the diaphragm to the left and right of the xyphoid process so as to expose the liver. Sterile 2-0 silk ligatures are then used to isolate both lobes simultaneously as close as possible to the inferior vena cava. The tissue is then resected distal to the ligature. The animals are closed with 5-0 silk, uninterrupted for the muscle and interrupted for the skin. Animals are administered bupranex (0.3 mg/kg in 3 mL NaCl, subcutaneously, Butler Schein, NY) and allowed to recover before returning to their cages. For the 85% PHTx, the surgery is identical to 70% with the addition of the right lower and caudate lobes. Liver specimens and blood samples were harvested at the indicated times before or after surgery and liver weights were also measured to calculate liver/body

weight ratios. For additional detailed methods, please refer to the RG7204 order Supporting Material. HO-1 is an accepted homeostatic and cytoprotective gene and when induced confers potent protection. To test the role of HO-1 in liver regeneration, we performed a 70% PHTx in wildtype (wt) and hmox−/− mice. Although wt mice all survived the surgery and resection, all hmox-1−/− mice died within the first 24-36

hours, which we believe is likely due, in large part, to surviving the surgical procedure and overall stress on the animal (Fig. 1A). We therefore moved away from using the hmox-1−/− mice and elected to use a pharmacological approach in wt mice using the well-characterized selective inhibitor of HO-1, tin protoporphyrin (Sn-PP). Administration of Sn-PP also resulted in increased mortality versus vehicle and wt controls, but was delayed over a longer period of time spanning 2-4 days when compared to the rapid mortality in the hmox-1 nulls, MCE公司 which we concluded was more related in part to poor liver regeneration (Fig. 1A). To assess the effects of Sn-PP on hepatocyte proliferation, we performed immunohistochemical staining of liver biopsies from hepatectomized animals with and without Sn-PP to assess basic architectural changes as well as to evaluate proliferating cell populations. Liver sections were stained with hematoxylin and eosin (H&E) or Ki67, a marker of proliferating cells, 48 hours after partial hepatectomy in the presence and absence of Sn-PP. We observed disrupted architecture, inflammatory infiltrates, and hemorrhage in the Sn-PP-treated mice that was minimal or absent in controls (H&E, Fig. 1B).

Hybrid+binge mice exhibit clinical features of AH such as a 2-fold increase in AST/ALT ratio compared to Hybrid ASH model, hypoalbuminemia (2.3+0.4g/dl), splenomegaly, and a 3-fold increase in plasma bilirubin. Hepatic myeloperox-idase (Myo) mRNA is increased 45-fold and correlates with neutrophilic infiltration (r=0.80, p<0.001). Spp, Cxcl1 (Gro),

and Il-17a implicated in inflammation, are induced 42, 86, learn more and 6.5 fold, respectively while Cd68 and Il-22 are repressed more than 10 fold. Hepatic TLR4 upregulation and activation as assessed by TLR4 IB and TRAF6/TAK1 co-IP, are most conspicuous in the AH model. Ingenuity analysis of AH vs. ASH livers reveals clusters of upregulated neutrophil- and tumor-associated genes and profoundly repressed metabolic (drug, lipid)

and transport genes in AH. Histological evidence of AH is evident in 50% (5/10) of Spp-/- mice subjected to the identical Hybrid+Binge regimen, and no differences are found in ALT and Myo, Cxcl1, Il-17a, and Il-22 expression compared to WT mice. [Conclusions] Alcohol binge in the hybrid mouse model selleck chemicals llc which produces ASH, triggers histological and pathophysio-logical features of AH, and Osteopontin has no role in this pathology. Disclosures: Hidekazu Tsukamoto – Consulting: Shionogi & Co., S.P. Pharmaceutics; Grant/Research Support: The Toray Co. The following people have nothing to disclose: Raul G. Lazaro, Akiko Ueno, Rylee Do, Nian-Ling Zhu, Raymond Wu, Jun Xu, Samuel W. French, Keigo Machida Background: Comorbidity increases the mortality of cirrhosis patients.

We developed a cirrhosis-specific comorbidity score (CirCom) and compared it with the universal Charlson Comorbidity Index that includes seventeen diseases. Methods: We used data from nationwide healthcare registries to identify Danish citizens diagnosed with cirrhosis in 1999%ndash;2008 (N=13,455). The majority had a history of alcoholism. They were followed through 2010 and characterized by 34 comor-bidities. We used Cox regression to assign severity weights to comorbidities 上海皓元医药股份有限公司 with a mortality hazard ratio ≥1.20 after adjustment for gender and age. Patients were subsequently characterized by their two most severe comorbidities which constituted their CirCom score. Discriminative ability was quantified with Harrell’s c statistic. The score was validated in a cohort of 419 patients with chart-validated alcoholic cirrhosis, adjusting for gender, age, MELD score, and alcohol drinking status. Results: Nine comorbidities had a hazard ratio ≥1.20: chronic obstructive pulmonary disease (severity weight=1), acute myocardial infarction (1), peripheral arterial disease (1), epilepsy (1), substance abuse other than alcoholism (1), heart failure (1), non-metastatic or hematologic cancer (1), chronic kidney disease (3), and metastatic cancer (3); 24.5% of patients had one or more of these, and CirCom scores ranged from 1+0 (N=2,511) to 3+3 (N = 1).

Hybrid+binge mice exhibit clinical features of AH such as a 2-fold increase in AST/ALT ratio compared to Hybrid ASH model, hypoalbuminemia (2.3+0.4g/dl), splenomegaly, and a 3-fold increase in plasma bilirubin. Hepatic myeloperox-idase (Myo) mRNA is increased 45-fold and correlates with neutrophilic infiltration (r=0.80, p<0.001). Spp, Cxcl1 (Gro),

and Il-17a implicated in inflammation, are induced 42, 86, INCB024360 clinical trial and 6.5 fold, respectively while Cd68 and Il-22 are repressed more than 10 fold. Hepatic TLR4 upregulation and activation as assessed by TLR4 IB and TRAF6/TAK1 co-IP, are most conspicuous in the AH model. Ingenuity analysis of AH vs. ASH livers reveals clusters of upregulated neutrophil- and tumor-associated genes and profoundly repressed metabolic (drug, lipid)

and transport genes in AH. Histological evidence of AH is evident in 50% (5/10) of Spp-/- mice subjected to the identical Hybrid+Binge regimen, and no differences are found in ALT and Myo, Cxcl1, Il-17a, and Il-22 expression compared to WT mice. [Conclusions] Alcohol binge in the hybrid mouse model click here which produces ASH, triggers histological and pathophysio-logical features of AH, and Osteopontin has no role in this pathology. Disclosures: Hidekazu Tsukamoto – Consulting: Shionogi & Co., S.P. Pharmaceutics; Grant/Research Support: The Toray Co. The following people have nothing to disclose: Raul G. Lazaro, Akiko Ueno, Rylee Do, Nian-Ling Zhu, Raymond Wu, Jun Xu, Samuel W. French, Keigo Machida Background: Comorbidity increases the mortality of cirrhosis patients.

We developed a cirrhosis-specific comorbidity score (CirCom) and compared it with the universal Charlson Comorbidity Index that includes seventeen diseases. Methods: We used data from nationwide healthcare registries to identify Danish citizens diagnosed with cirrhosis in 1999%ndash;2008 (N=13,455). The majority had a history of alcoholism. They were followed through 2010 and characterized by 34 comor-bidities. We used Cox regression to assign severity weights to comorbidities MCE公司 with a mortality hazard ratio ≥1.20 after adjustment for gender and age. Patients were subsequently characterized by their two most severe comorbidities which constituted their CirCom score. Discriminative ability was quantified with Harrell’s c statistic. The score was validated in a cohort of 419 patients with chart-validated alcoholic cirrhosis, adjusting for gender, age, MELD score, and alcohol drinking status. Results: Nine comorbidities had a hazard ratio ≥1.20: chronic obstructive pulmonary disease (severity weight=1), acute myocardial infarction (1), peripheral arterial disease (1), epilepsy (1), substance abuse other than alcoholism (1), heart failure (1), non-metastatic or hematologic cancer (1), chronic kidney disease (3), and metastatic cancer (3); 24.5% of patients had one or more of these, and CirCom scores ranged from 1+0 (N=2,511) to 3+3 (N = 1).

The effect was not color-specific and was greatest for the 12 cpd gratings. Given the significant associations between the achromatic discomfort measures and reports of visual triggers, and the lack of significant associations between the chromatic discomfort measures and reports of visual triggers, further research is recommended to explore the potential to reduce the number of visually triggered migraines with color in addition to alleviating visual Palbociclib discomfort. “
“Background.— Though triptans are considered the standard of acute therapy for migraine attacks with headache-related disability, they are used by the minority of potentially eligible persons. Understanding

the socio-demographic and headache features that predict triptan use may help to clarify barriers to optimal treatment. Objective.— To assess the sociodemographic and headache features associated with triptan use in a US population sample of persons with episodic migraine. Methods.— The American Migraine Prevalence and Prevention Study (AMPP) is a longitudinal study conducted in a representative sample of US headache sufferers. Episodic migraineurs (n = 11,388) who provided treatment data in 2005 were included in the current analyses. We assessed factors associated with triptan use

AZD1152-HQPA research buy through univariate and multivariate analyses. Multivariate analyses were adjusted for sociodemographic factors, headache-related disability, cutaneous

allodynia, depression, and preventive headache medication use. Results.— Among persons with episodic migraine, 18.31% reported current use of triptans for acute headache treatment. In univariate analyses, medchemexpress triptan use was most common in midlife (ages 30-59), among females, and was more common in Caucasians than in African Americans. Triptan use increased with headache frequency, headache-related disability and allodynia, but decreased among persons with depression. In multivariate analyses, female gender, Caucasian race, age 40-49, higher levels of education (college or higher), annual household income of ≥$40,000, having health insurance, the presence of cutaneous allodynia, greater headache-related disability, and preventive medication use for migraine were significantly associated with triptan use. Conclusions.— Less than 1 in 5 persons with migraine in the United States who were respondents to this survey used triptans for acute headache treatment over the course of a year. Several markers of severe headache, including disability and allodynia, were associated with increased triptan use. Groups less likely to get triptans included males, African Americans, older adults, and the uninsured. Predictors of use provide insight into groups with unmet treatment needs.

The effect was not color-specific and was greatest for the 12 cpd gratings. Given the significant associations between the achromatic discomfort measures and reports of visual triggers, and the lack of significant associations between the chromatic discomfort measures and reports of visual triggers, further research is recommended to explore the potential to reduce the number of visually triggered migraines with color in addition to alleviating visual this website discomfort. “
“Background.— Though triptans are considered the standard of acute therapy for migraine attacks with headache-related disability, they are used by the minority of potentially eligible persons. Understanding

the socio-demographic and headache features that predict triptan use may help to clarify barriers to optimal treatment. Objective.— To assess the sociodemographic and headache features associated with triptan use in a US population sample of persons with episodic migraine. Methods.— The American Migraine Prevalence and Prevention Study (AMPP) is a longitudinal study conducted in a representative sample of US headache sufferers. Episodic migraineurs (n = 11,388) who provided treatment data in 2005 were included in the current analyses. We assessed factors associated with triptan use

3-MA supplier through univariate and multivariate analyses. Multivariate analyses were adjusted for sociodemographic factors, headache-related disability, cutaneous

allodynia, depression, and preventive headache medication use. Results.— Among persons with episodic migraine, 18.31% reported current use of triptans for acute headache treatment. In univariate analyses, 上海皓元 triptan use was most common in midlife (ages 30-59), among females, and was more common in Caucasians than in African Americans. Triptan use increased with headache frequency, headache-related disability and allodynia, but decreased among persons with depression. In multivariate analyses, female gender, Caucasian race, age 40-49, higher levels of education (college or higher), annual household income of ≥$40,000, having health insurance, the presence of cutaneous allodynia, greater headache-related disability, and preventive medication use for migraine were significantly associated with triptan use. Conclusions.— Less than 1 in 5 persons with migraine in the United States who were respondents to this survey used triptans for acute headache treatment over the course of a year. Several markers of severe headache, including disability and allodynia, were associated with increased triptan use. Groups less likely to get triptans included males, African Americans, older adults, and the uninsured. Predictors of use provide insight into groups with unmet treatment needs.

Compared with IFX, ADA tended to have longer time to reinduction (median 22 vs 37 months respectively, p = 0.07) and longer time from reinduction to objective reinduction failure (median 11 vs 21, p = 0.60), albeit the latter was non-significant. Post-reinduction, factors associated at least 12 months continuation on same anti-TNF included, for both ADA and IFX, no current IBD extra-intestinal

manifestation(s) OR 10.5, 95% CI [1.5,71.4](p = 0.01), no psychological comorbidity OR 6.7 [1.05, 42.4] (each p < 0.05), female sex OR 3.9 [0.8, 21.3](p = 0.1). Again, female sex was associated with continuation at 12 months post-induction for ADA (Fisher's exact, p < 0.04) but not for IFX (p = 0.65). Conversely, concurrent thiopurine was associated with continuation (at 12 m) for IFX (p < 0.05) but not for ADA (p = 0.3) FDA approved Drug Library cost and there was a trend for prior bowel resection to be associated with continuation for IFX but no ADA (p = 0.06). Conclusions: Overall reinduction was very effective in regaining response to anti-TNF in many patients, and should be considered in patients as the next step where concomitant immunomodulators have already been added. Smoking rates are high in this cohort, implying its important role

in secondary LOR. Pharmacokinetic DMXAA price differences between ADA and IFX, with the potentially greater immunogenic potential of IFX, may explain why concurrent 上海皓元医药股份有限公司 thiopurines were linked with more durable outcomes in IFX post-reinduction (but not ADA), and the differential response post-reinduction for ADA

between males and females. Further larger studies are needed in this area to best utilize anti-TNF reinduction to achieve optimal outcomes in the Australian PBS setting in CD. M OOI, J PANETTA, M ZHU, C CORTE, RWL LEONG Gastroenterology and Liver Services, Concord Hospital, Sydney Australia Background: Traditional forward-viewing colonoscopy (FVC) is impeded by a narrow field of view of <170 degrees with adenoma “miss-rates” of 24–42%. This limitation impairs dysplasia surveillance in chronic colitis. Chromoendoscopy improves visualization of dysplasia but has never been used with FUSE, which provides 330 degree visualization. This study compares FVC and FUSE with and without chromoendoscopy for the identification of dysplasia in IBD. Methods: This was a prospective, randomized-order, crossover tandem colonoscopy trial at an academic IBD center. Inclusion criteria were left sided or extensive colitis for >10 years disease duration, primary sclerosing cholangitis (PSC) or previous dysplasia. Patients underwent same-day, back-to-back tandem colonoscopy with FVC (PCF/CF 180/190, Olympus, Japan) and the FUSE colonoscope (EndoChoice, USA) under propofol sedation. Order randomization was computer-generated. Patients and endoscopist were masked to group allocation until immediately prior to colonoscopy.

Compared with IFX, ADA tended to have longer time to reinduction (median 22 vs 37 months respectively, p = 0.07) and longer time from reinduction to objective reinduction failure (median 11 vs 21, p = 0.60), albeit the latter was non-significant. Post-reinduction, factors associated at least 12 months continuation on same anti-TNF included, for both ADA and IFX, no current IBD extra-intestinal

manifestation(s) OR 10.5, 95% CI [1.5,71.4](p = 0.01), no psychological comorbidity OR 6.7 [1.05, 42.4] (each p < 0.05), female sex OR 3.9 [0.8, 21.3](p = 0.1). Again, female sex was associated with continuation at 12 months post-induction for ADA (Fisher's exact, p < 0.04) but not for IFX (p = 0.65). Conversely, concurrent thiopurine was associated with continuation (at 12 m) for IFX (p < 0.05) but not for ADA (p = 0.3) JNK inhibitor and there was a trend for prior bowel resection to be associated with continuation for IFX but no ADA (p = 0.06). Conclusions: Overall reinduction was very effective in regaining response to anti-TNF in many patients, and should be considered in patients as the next step where concomitant immunomodulators have already been added. Smoking rates are high in this cohort, implying its important role

in secondary LOR. Pharmacokinetic selleck kinase inhibitor differences between ADA and IFX, with the potentially greater immunogenic potential of IFX, may explain why concurrent MCE公司 thiopurines were linked with more durable outcomes in IFX post-reinduction (but not ADA), and the differential response post-reinduction for ADA

between males and females. Further larger studies are needed in this area to best utilize anti-TNF reinduction to achieve optimal outcomes in the Australian PBS setting in CD. M OOI, J PANETTA, M ZHU, C CORTE, RWL LEONG Gastroenterology and Liver Services, Concord Hospital, Sydney Australia Background: Traditional forward-viewing colonoscopy (FVC) is impeded by a narrow field of view of <170 degrees with adenoma “miss-rates” of 24–42%. This limitation impairs dysplasia surveillance in chronic colitis. Chromoendoscopy improves visualization of dysplasia but has never been used with FUSE, which provides 330 degree visualization. This study compares FVC and FUSE with and without chromoendoscopy for the identification of dysplasia in IBD. Methods: This was a prospective, randomized-order, crossover tandem colonoscopy trial at an academic IBD center. Inclusion criteria were left sided or extensive colitis for >10 years disease duration, primary sclerosing cholangitis (PSC) or previous dysplasia. Patients underwent same-day, back-to-back tandem colonoscopy with FVC (PCF/CF 180/190, Olympus, Japan) and the FUSE colonoscope (EndoChoice, USA) under propofol sedation. Order randomization was computer-generated. Patients and endoscopist were masked to group allocation until immediately prior to colonoscopy.

4 In brief, the Virahep-C study evaluated clinical, immunological, virological, and host genetic factors that contribute to the lack of virological response to antiviral treatment and, in particular, the racial difference in efficacy. The study enrolled approximately equal numbers of Caucasian Americans (CAs) (n = 205) and African Americans (AAs) (n = 196), all of whom underwent combination PEG-IFN and ribavirin therapy for up to 48 weeks. At 24 weeks of therapy, patients were evaluated for the presence of HCV RNA; those with detectable levels of

HCV RNA were labeled as nonresponders and discontinued therapy, and the remaining patients continued therapy for an additional 24 weeks. All patients were followed for an additional 24 weeks after completion of therapy.

The study protocol conformed to the ethical guidelines of the 1975 Declaration of Helsinki as reflected in a priori approval Enzalutamide cost by the local institutional review board. Of Vismodegib datasheet the 401 participants enrolled in Virahep-C, lipid profile analyses were performed among participants who granted genetic consent (n = 374) approved by the local institutional review board and had stored fasting serum samples at baseline (n = 335). Five participants who reported use of lipid-lowering medications were excluded from this evaluation, resulting in a final analysis sample of 330 participants (160 AAs and 170 CAs). During treatment (24 weeks after starting therapy) and after treatment (24 weeks after stopping therapy), lipid profile data were additionally available for 253 and 245 of the participants, respectively. The primary outcome for Virahep-C

was SVR, defined as undetectable serum HCV RNA 24 weeks after the end of therapy. Serum lipid measures, TG, LDLc, high-density lipoprotein cholesterol (HDLc), and TC were obtained through analysis of stored fasting serum samples at the Heinz Nutrition Laboratory in the Department of Epidemiology, University medchemexpress of Pittsburgh. For serum samples with TG levels <400 mg/dL, the Friedewald formula was used to calculate LDLc indirectly (TC − HDLc − 0.20 × TG).32 For samples with TG levels of at least 400 mg/dL, LDLc was assessed directly. Dyslipidemia was defined using the cutoffs from the National Cholesterol Education Program Adult Treatment Panel III recommendations as any of the following: LDLc ≥130 mg/dL, HDLc <40 mg/dL, TC ≥200 mg/dL, or TG ≥150 mg/dL.33 A homeostasis model assessment (HOMA) variable, HOMA2, was calculated using fasting insulin and glucose measures with a Microsoft Excel HOMA2 calculator and insulin resistance was defined as a score ≥2.34 Hepatic inflammation and fibrosis were assessed using the criteria of the histological activity index by a single hepatopathologist.35, 36 The amount of PEG-IFN and ribavirin taken by participants was estimated using data from the Medication Event Management System (Aardex, Zug, Switzerland).

4 In brief, the Virahep-C study evaluated clinical, immunological, virological, and host genetic factors that contribute to the lack of virological response to antiviral treatment and, in particular, the racial difference in efficacy. The study enrolled approximately equal numbers of Caucasian Americans (CAs) (n = 205) and African Americans (AAs) (n = 196), all of whom underwent combination PEG-IFN and ribavirin therapy for up to 48 weeks. At 24 weeks of therapy, patients were evaluated for the presence of HCV RNA; those with detectable levels of

HCV RNA were labeled as nonresponders and discontinued therapy, and the remaining patients continued therapy for an additional 24 weeks. All patients were followed for an additional 24 weeks after completion of therapy.

The study protocol conformed to the ethical guidelines of the 1975 Declaration of Helsinki as reflected in a priori approval Palbociclib in vitro by the local institutional review board. Of selleck the 401 participants enrolled in Virahep-C, lipid profile analyses were performed among participants who granted genetic consent (n = 374) approved by the local institutional review board and had stored fasting serum samples at baseline (n = 335). Five participants who reported use of lipid-lowering medications were excluded from this evaluation, resulting in a final analysis sample of 330 participants (160 AAs and 170 CAs). During treatment (24 weeks after starting therapy) and after treatment (24 weeks after stopping therapy), lipid profile data were additionally available for 253 and 245 of the participants, respectively. The primary outcome for Virahep-C

was SVR, defined as undetectable serum HCV RNA 24 weeks after the end of therapy. Serum lipid measures, TG, LDLc, high-density lipoprotein cholesterol (HDLc), and TC were obtained through analysis of stored fasting serum samples at the Heinz Nutrition Laboratory in the Department of Epidemiology, University MCE of Pittsburgh. For serum samples with TG levels <400 mg/dL, the Friedewald formula was used to calculate LDLc indirectly (TC − HDLc − 0.20 × TG).32 For samples with TG levels of at least 400 mg/dL, LDLc was assessed directly. Dyslipidemia was defined using the cutoffs from the National Cholesterol Education Program Adult Treatment Panel III recommendations as any of the following: LDLc ≥130 mg/dL, HDLc <40 mg/dL, TC ≥200 mg/dL, or TG ≥150 mg/dL.33 A homeostasis model assessment (HOMA) variable, HOMA2, was calculated using fasting insulin and glucose measures with a Microsoft Excel HOMA2 calculator and insulin resistance was defined as a score ≥2.34 Hepatic inflammation and fibrosis were assessed using the criteria of the histological activity index by a single hepatopathologist.35, 36 The amount of PEG-IFN and ribavirin taken by participants was estimated using data from the Medication Event Management System (Aardex, Zug, Switzerland).