Pioglitazone on Viral Kinetics, Cytokines and Innate Immunity in Insulin Resistant CHC GT 1 Subjects

Inclusion Criteria: * HCV-Ab or HCV-RNA by PCR Positive for at least six months (to rule out acute seroconversion) * Serum positive for HCV-RNA by PCR assay * Must have insulin resistance, defined as a QUICKI score \< 0.35. QUICKI * Liver biopsy consistent with CHC within 24 months prior to enrollment * Compensated liver disease with the following minimum hematological, biochemical, and serologic criteria at the Screening Visit (WNL = within normal limits): * Hemoglobin values of \>12 gm/dL for females and \>13 gm/dL for males. * WBC \>3,000/ mm3 * Neutrophil count \> 1,500/mm3 * Platelets \>65,000/ mm3 * Direct bilirubin, within 20% of ULN * Indirect bilirubin, within normal limits (WNL) * Albumin \>3gm/dL * Serum creatinine \< 20% above the ULN * TSH WNL * Alpha fetoprotein value \< 100 ng/mL Exclusion Criteria: * Prior interferon based therapy * Use of insulin * Fasting glucose levels \> 200 mg/dl * Women who are pregnant or breast-feeding * No other thiazolidinedione after liver biopsy and/or during the entire study ( * Hepatitis C of non-genotype 1 * Suspected hypersensitivity to pioglitazone * Any cause for liver disease other than chronic hepatitis C, insulin resistance, or NAFLD, including but not limited to: * Hemochromatosis * Alpha-1 antitrypsin deficiency * Co-infection with HBV * Wilson's disease * Autoimmune hepatitis * Significant alcohol use * Drug-related liver disease * Any condition that would prevent the subject from having a liver biopsy. * Hemoglobinopathies that could potentially compromise patient safety * Evidence of advanced liver disease such as history or presence of ascites, bleeding varices, spontaneous encephalopathy. * Participants with organ transplants other than cornea and hair transplant. * Any known preexisting medical condition that could interfere with the subject's participation in and completion of the protocol such as: * Preexisting psychiatric condition, especially severe depression, or a history of severe psychiatric disorder, such as major psychoses, suicidal ideation and/or suicidal attempt are excluded * Substance abuse, such as alcohol, IV drugs and inhaled drugs * Alcohol consumption is to be strongly discouraged * Seizure disorders not controlled with medication * Significant cardiovascular dysfunction within the past 12 months * Chronic pulmonary disease with documented pulmonary hypertension * Immunologically mediated disease \[e.g., inflammatory bowel disease (Crohn's disease, ulcerative colitis)\], rheumatoid arthritis, idiopathic thrombocytopenia purpura, systemic lupus erythematosis, autoimmune hemolytic anemia, scleroderma, severe psoriasis, clinical cryoglobulinemia with vasculitis * Any medical condition requiring, or likely to require, chronic systemic administration of steroids during the course of the study * Evidence of an active or suspected cancer or a history of malignancy where the risk of reoccurrence is ≥ 20% within two years