Insulin resistance is a predictor of poor response to PEG-IFN-α and ribavirin in patients with chronic HCV infection, but data are lacking for direct-acting antivirals. Serfaty et al. investigated the prognostic significance of insulin resistance in 161 treatment-naive patients infected with HCV genotype 1, who received telaprevir followed by PEG-IFN-α and ribavirin. Insulin resistance was not found to be predictive of virologic response to telaprevir.