Effect of Direct Acting Anti-viral Agents on Insulin Resistance in Chronic HCV Patients

Abstract

Background: HCV infection is a major cause of chronic liver disease worldwide, ultimately leading to cirrhosis and hepatocellular carcinoma. Globally, it is estimated that up to 185 million people have been infected with HCV, and among these, according to the World Health Organization, ~ 130–150 millions are chronically infected. Recent estimates place to ~ 700,000 the yearly death toll of liver-related, long-term sequelae of HCV. In many regions of the world, where access to therapy is available, the number of deaths due to HCV has even surpassed. Aim of the work: The goals of our study is to evaluate the effect of direct antiviral agents (DAAs) on insulin resistance in chronic HCV patients receiving (daclatasvir + sofosbuvir +- ribavirin) for 12 weeks and 12 weeks post treatment. Methodology: The study was conducted at, Gastroenterology and Hepatology Unit, Police Authority Hospitals. It included 80 patients with chronic HCV infection (treatment naive patients). Patients were classified in to 4 groups: Group 1: 20 non diabetic, non-obese patients; Group 2: 20 diabetic, non-obese patients; Group 3: 20 obese, non-diabetic patients and Group 4: 20 diabetic, obese patients. Results: The current study showed highly significant decrease in HOMA-IR in all groups at end of treatment and 12 weeks post treatment. Conclusion: Antiviral therapy (DAAs) improves insulin resistance during HCV treatment. These findings suggest that HCV plays an etiological role in the pathogenesis of impaired glucose homeostasis. Moreover, the decrease of insulin resistance through viral eradication implicates clinical benefits by readily available regimens. Recommendations: Confirmation of the current results by conduction of larger scale studies.