INS and Insulin resistance: These changes were reflected in an improved HOMA-IR index, which is consistent with a recent report of significant reductions in HOMA-insulin resistance and an increase in HOMA-insulin sensitivity following HCV clearance by DAA treatment [50]; however, as with lipid metabolism, some studies have found no such changes [25,45,46], which can be explained, at least partially, by a genotype-dependent effect whereby an improvement in carbohydrate metabolism occurs in those patients infected with HCV genotype 1 [51].