Aim. To assess the effect of treating chronic hepatitis C virus (HCV) infection with direct acting antiviral drugs (DAAs) on glycemic control in patients with concomitant diabetes mellitus (DM). Methods. We performed a retrospective case-control study in a viral hepatitis ambulatory clinic in Shreveport, Louisiana, during the period 11/01/2014 to 12/31/2017. All the clinic patient ages 18 years and above with treatment-naïve/biopsy-proven chronic hepatitis C and DM (hemoglobin A1C level≥6.5%) who were eligible for treatment were included in the study. Of 118 such patients, 59 were treated with oral DAAs for 8-12 weeks with the goal of achieving a sustained virologic response (SVR). A control group of 59 patients did not receive treatment for their hepatitis C and was followed in the clinic. Patients in the control group did not receive treatment either due to insurance issues or refusal of hepatitis C treatment. Results. Fifty-five of the 59 patients treated with DAAs (93%) achieved a SVR. Six months after treatment completion, their mean±SEM HbA1C level had decreased by 1.1±0.03% (P<0.0001). Four of the 59 patients treated with DAAs did not achieve a SVR. Their mean HbA1C 6 months after treatment completion had increased by 0.8±0.2%. Furthermore, there was no improvement in HbA1C levels over time in the untreated group (mean HbA1C increase, 0.2±0.05%; P<0.0001 vs. the treatment group, which had a mean HbA1C decrease of 0.9±0.2%). Conclusion. This controlled study demonstrated that treatment of chronic hepatitis C with DAAs results in statistically significant and meaningful reductions in hemoglobin A1C levels in patients with coexisting diabetic mellitus if a SVR is achieved.
Background Due to the slow progression of many chronic liver diseases, including hepatitis C, it is not practical or safe to monitor disease progression by serial liver biopsies. Noninvasive laboratory scoring systems based on routine laboratory tests are appealing surrogate markers of liver fibrosis for the staging and monitoring of chronic liver diseases such as hepatitis C. Methods We explored the accuracy of three scoring systems: the fibrosis-4 score (FIB-4), the aspartate aminotransferase to platelet ratio index (APRI score), and the aspartate aminotransferase to alanine aminotransferase ratio (AAR) in 496 patients with chronic hepatitis C virus (HCV) infection who had undergone percutaneous liver biopsy at a viral hepatitis clinic in Shreveport, Louisiana. Results For FIB-4, the area under the receiver operating characteristic curve (AUROC) for hepatic fibrosis stages ≥ 1, ≥ 2, ≥ 3, and 4 (cirrhosis) ranged from 0.74 (95% CI, 0.678-0.802) to 0.802 (95% CI, 0.751-0.854). At a cutoff value of 1.45, FIB-4 was 82% sensitive for advanced fibrosis or cirrhosis (stage 3 or 4) but was only 58% specific for these findings. Increasing the FIB-4 cutoff value to 3.25 reduced the sensitivity for detecting advanced fibrosis or cirrhosis to 39%, but this higher cutoff was 92% specific for these findings. Corresponding AUROCs for the APRI and AAR scores were inferior to FIB-4. Conclusion The FIB-4 index outperformed APRI and AAR in our HCV infected population in predicting severe fibrosis or cirrhosis.
BackgroundHepatitis C virus (HCV) infection is one of the leading causes of mortality and morbidity in the United States with an incidence of about 0.7 cases per 100,000 population and a prevalence of ~2.7 to 3.9 million people. To our knowledge only one study was performed so far to assess the relation between treating hepatitis C virus using direct acting antiviral drugs (DAA) and reduction in the severity of type 2 diabetes mellitus (DM). Our study aims to assess the effect of SVR in hepatitis C virus on type 2 DM. The effect of the management with newer agents leading to sustained virologic response (SVR) on type 2 DM was analyzed in hepatitis C virus infection.MethodsWe performed a retrospective chart review in our hepatitis clinic located in Shreveport, Louisiana. Patients with age greater than 18 years old, who has both uncontrolled hepatitis C and type 2 DM, seen in our clinic from November 1, 2014 to December 31, 2017 were included. Hospital electronic health records were screened for diagnosis of hepatitis C and uncontrolled type 2 DM by ICD codes. We performed paired sample t-test between pre- and 6-month post-treatment-values of fasting blood sugar and Body Mass Index (BMI).ResultsThere was a statistically significant improvement in fasting blood sugar levels following hepatitis C therapy from 184.2 ± 74.8 to 133.06 ± 48.2 (P < 0.01), with an improvement of 51.2 ± 77.6 respectively (N = 49).There was a statistically significant improvement in HbA1c levels following hepatitis C therapy from 8.062 ± 1.8 to 7.019 ± 0.96 (P < 0.05), with an improvement of 1.042 ± 2.03 respectively (N = 21).There was no statistically significant improvement in BMI levels following hepatitis C therapy from 29.91 ± 6.6 to 29.79 ± 6.7 (P > 0.05), with slight improvement of 0.11 ± 2.08 respectively (N = 49).ConclusionWe conclude that there was statistical significant reduction in fasting blood sugar and hemoglobin A1C levels after achieving sustained virological response with new direct antiviral treatment for hepatitis C. A pre- and posttreatment change in body mass index was statistically not significant implies that change in blood sugar level was not due to weight loss. There was no change in diabetic medication during the period of the study or there were no dose adjustments occurred.Disclosures All authors: No reported disclosures.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.