TNF and cryohydrocytosis: Insulin resistance (IR) is more frequent in chronic hepatitis C (CHC) than in other chronic liver diseases.1 Hepatitis C virus (HCV) chronic infection directly causes IR by interfering with insulin signaling cascade,2 mainly through the interaction between the HCV core protein at several steps of this cascade,3,4 but also by upregulating the production of proinflammatory cytokines, such as tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6).