This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. There have been several studies that link the presence of fatty liver in patients with viral hepatitis C and the amount of scarring or disease progression in the liver. This accumulation of fat in the liver may be due to insulin resistance. In this study, we would like to test whether patients treated with an FDA approved drug for diabetes, Pioglitazone (or Actos) will: A. Help reduce insulin resistance, which has been shown to be a key factor in causing fatty liver in patients with non-alcoholic fatty liver disease. B. Assess whether the amount of fat in the liver improves during drug treatment, which may improve the amount of fibrosis (or scarring) in the liver. C. Discover if patients being treated with Actos along with the established combination therapy, Ribaviron and Interferon, will respond better overall, to treatment for viral hepatitis C. We plan to conduct a double-blind, placebo controlled study where the subject will undergo the normal 48 weeks of treatment for hepatitis C, in addition to the study medication (pioglitazone or placebo) with histologic evaluation of the liver before treatment and at the end of 48 weeks of therapy in the study in order to assess histologic improvement.
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