Effect of hepatitis C eradication with DAA on type II diabetes mellitus control as regard insulin resistance & lipid profile

Abstract

Abstract Background Patients with chronic hepatitis C have both higher prevalence of diabetes mellitus type 2 (T2DM) and increased cardiovascular risk compared to never infected people. The patients with chronic HCV infection can have fatty liver, hypobetalipoproteinemia, and hypercholesterolemia that may cause lipid and lipid protein metabolism disorders. Objective To determine the effect of HCV eradication (SVR 12) on type II Diabetic patients as regard insulin resistance & lipid profile. Patients and Methods This study was conducted at the gastroenterology and hepatology unit, Ain shams university hospital and Ahmed Maher teaching hospital, Written informed consent was obtained from all subjects before participating in this study. 100 Egyptian patients with chronic hepatitis C and type II Diabetes mellitus were recruited and received (sofosbuvir & daclatasvir) for 3 months. patients continue on same antidiabetics all over the study. Results The data from the present study provide evidence of an improvement in IR after clearance of HCV by oral DAA regimen. On the basis of these data, it is possible to hypothesize that HCV clearance by DAAs improving IR and reducing stress on beta-cell function prevents or delay the development of type 2 diabetes mellitus and/or metabolic syndrome in chronic HCV infected patients. Conclusion The overall data of this study show that glycemic control improves in patients with diabetes after DAA induced SVR. Patients not only have an improvement in HbA1c level after achieving SVR, they are also less likely to require insulin. the viral clearance due to DAA also led to an improvement of glucose metabolism associated with a global worsening of lipid profile. The HCV clearance by DAA treatment reverses or improves IR and reduces stress on beta-cell function by emphasizing the role of HCV in the development of IR and that this result can prevent IR-related pathological conditions such as worsening liver fibrosis, development of type 2 diabetes, metabolic syndrome and cardio-vascular disorders.