【Abstract】Objective Inflammation status and proinflammatory cytokines can led to insulin resistance. Hepatitis C virus infection is often associated with the increase of proinflammatory cytokine levels. Similar changes are seen in maintain hemodialysis patients. Does hepatitis C virus infection in maintain hemodialysis patients aggravate these changes? The purpose of this study was to investigate the influence of hepatitis C virus infection on proinflammatory cytokines and insulin resistance in maintain hemodialysis patients. Method We recruited 72 patients on regular hemodialysis 2-3 times a week for at least 6 months. Twenty-one of them (13 males and 8 females, with average dialysis duration of 53.39±20.88 months) were anti-HCV antibody (+), and defined as the HCV(+) group. The remaining 51 patients (29 males and 22 females, with average dialysis duration of 31.95±18.15 months) were negative for HCV and other hepatitis virus, and were defined as the HCV(-) group. None of the patients had a history of drug use or any other diseases that were related to insulin resistance except uremia. Fasting glucose, fasting insulin, fasting C peptide, TNF-α and CRP were assayed, and the serum samples for the assays were taken after 12 hours of fasting. Insulin resistance was calculated according to the HOMA formula. Patient was defined as HOMA-IR (+) if the score was higher than 2.5. Results There were no significant difference in fasting glucose and C-peptide between the two groups. Fasting insulin and HOMA-IR score were higher in HCV(+) group than in HCV(-) group (insulin 12.18±3.05pmol/L vs. 10.52±2.98pmol/L, P=0.037; HOMA-IR 2.67±0.87 vs. 2.21±0.75, P =0.027). HOMA-IR score higher than 2.5 was found in 11 of 21 (52.38%) HCV(+) patients and 18 of 51 (35.29%) HCV(-) patients. The serum levels of TNF-α and CRP were significantly higher in HCV(+) group (0.34±0.11mg/dl and 22.09±7.16pg/ml, respectively) than in HCV(-) group (0.12±0.04mg/dl and 10.31±4.87pg/ml, respectively). HOMA-IR score was positively correlated with the levels of TNF-α (r=0.537, P=0.003) and CRP (r=0.439, P =0.004). Conclusion In maintain hemodialysis patients, HCV infection can aggravate the microinflammatory status and lead to insulin resistance.