Abstract

BackgroundA burden of data suggests that insulin signaling could be impaired with hepatitis C virus infection, and this boost the onset of type 2 diabetes mellitus beyond and in addition to the histological effect on the associated liver disease. We aimed to evaluate the hemoglobin A1c (HbA1c) levels before and after therapy with direct-acting antivirals (DAAs) in HCV-diabetic patients who achieved sustained virological response (SVR) at Aswan Fever Hospital. This prospective study was conducted at the Viral Hepatitis Treatment Center, Aswan Fever Hospital, Aswan, Egypt, between November 2017 and May 2018. A total of 85 randomly selected diabetic patients (type 2 diabetes mellitus) with chronic HCV infection were received sofosbuvir and daclatasvir as a dual therapy for 3 months, then followed up for week 12 after the end of DAA therapy, Changes in the levels of hemoglobin A1c (HbA1c) were measured at baseline then 12 weeks after the end of treatment with DAAs.ResultsThirty-two patients (37.6%) showed a significant glycemic improvement after receiving DAAs therapy; in the form of > 1% reduction in HbA1c level (p value < 0.001). Their baseline mean HbA1c level was 7.98 ± 0.62% which was significantly improved 12 weeks after the end of therapy (SVR) to reach a level of 6.88 ± 0.81%. Meanwhile, 53 patients (62.4%) had a baseline mean HbA1c of 8.24 ± 0.64% and a post-treatment mean HbA1c level of 8.34 ± 0.61% (p value = 0.083).ConclusionDAAs-based eradication of HCV is associated with improved glycemic control in 37.6% of patients with diabetes as evidenced by a significant reduction of mean HbA1c.

Highlights

  • A burden of data suggests that insulin signaling could be impaired with hepatitis C virus infection, and this boost the onset of type 2 diabetes mellitus beyond and in addition to the histological effect on the associated liver disease

  • The current body of evidence shows a higher prevalence of type 2 diabetes mellitus (T2DM) among patients with chronic Hepatitis C virus (HCV) infection, it was proposed that HCV proteins increase serine and threonine phosphorylation of insulin receptor substrate-1, which contributes to insulin resistance

  • Glycemic improved group: ≥ 1% reduction of baseline hemoglobin A1c (HbA1c) levels at sustained virological response (SVR)

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Summary

Introduction

A burden of data suggests that insulin signaling could be impaired with hepatitis C virus infection, and this boost the onset of type 2 diabetes mellitus beyond and in addition to the histological effect on the associated liver disease. We aimed to evaluate the hemoglobin A1c (HbA1c) levels before and after therapy with direct-acting antivirals (DAAs) in HCV-diabetic patients who achieved sustained virological response (SVR) at Aswan Fever Hospital. This prospective study was conducted at the Viral Hepatitis Treatment Center, Aswan Fever Hospital, Aswan, Egypt, between November 2017 and May 2018. A total of 85 randomly selected diabetic patients (type 2 diabetes mellitus) with chronic HCV infection were received sofosbuvir and daclatasvir as a dual therapy for 3 months, followed up for week 12 after the end of DAA therapy, Changes in the levels of hemoglobin A1c (HbA1c) were measured at baseline 12 weeks after the end of treatment with DAAs. Hepatitis C virus (HCV) affects over 185 million people, with an estimated 2.8% increase globally over the last decade. Several studies focused on the treatment of HCV with pegylated interferon (peg)/ribavirin (RBV) based therapy prior to the widespread use of the new direct-acting antiviral drugs (DAAs) [5]

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