Diabetes mellitus, insulin resistance and hepatitis C virus infection: A contemporary review

Abstract

AIMTo summarise the literature data on hepatitis C virus (HCV)-infected patients concerning the prevalence of glucose abnormalities and associated risk.METHODSWe conducted a PubMed search and selected all studies found with the key words "HCV" or "hepatitis C virus" and "diabetes" or "insulin resistance". We included only comparative studies written in English or in French, published from January 2000 to April 2015. We collected the literature data on HCV-infected patients concerning the prevalence of glucose abnormalities [diabetes mellitus (DM) and insulin resistance (IR)] and associated risk [i.e., severe liver fibrosis, response to antivirals, and the occurrence of hepatocellular carcinoma (HCC)].RESULTSHCV infection is significantly associated with DM/IR compared with healthy volunteers and patients with hepatitis B virus infection. Glucose abnormalities were associated with advanced liver fibrosis, lack of sustained virologic response to interferon alfa-based treatment and with a higher risk of HCC development. As new antiviral therapies may offer a cure for HCV infection, such data should be taken into account, from a therapeutic and preventive point of view, for liver and non-liver consequences of HCV disease. The efficacy of antidiabetic treatment in improving the response to antiviral treatment and in decreasing the risk of HCC has been reported by some studies but not by others. Thus, the effects of glucose abnormalities correction in reducing liver events need further studies.CONCLUSIONGlucose abnormalities are strongly associated with HCV infection and show a negative impact on the main liver related outcomes.

Non-invasive quantification of liver fibrosis regression following successful treatment of chronic hepatitis C with direct acting antivirals

“…We identified a significant inverse correlation between the duration of HCV infection and the quantitative decrease in liver stiffness, r s =-0.326, p=0.017, N=53, but this association was not statistically significant when comparing the qualitative regression in liver fibrosis, despite the fact that patients who achieved a one stage decrease in fibrosis had a slightly lower median (IQR) duration of HCV infection, 12 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16) years, compared with those who did not achieve regression of liver fibrosis, 13.5 (9-16) years (U=320.5, p=0.578, r=0.08).…”

“…We also assessed whether there is an association between the regression of liver fibrosis with classical prognostic factors previously used for calculating the chance of obtaining SVR following interferon-based treatment, such as: younger age (7,8), female gender (9), IL28B CC rs12979860 (10) or other genetic polymorphisms (11,12), baseline viral load below 600,000 IU/mL (13,14), absence of diabetes mellitus (15), shorter duration of HCV infection (16) calculated as the time (years) since the first positive anti-HCV test, and absence of surrogate markers for advanced liver disease at baseline.…”

Hepatitis C virus core protein induces hepatic steatosis via Sirt1‐dependent pathway

“…In addition to hepatic steatosis, several studies have reported the correlation of hepatitis C virus and diabetes mellitus . As we all know, obesity and lipid metabolism disorders often affect glucose homeostasis.…”

Regulation of insulin resistance and type II diabetes by hepatitis C virus infection: A driver function of circulating miRNAs

“…Among these extrahepatic complications, a growing body of evidence has particularly shown that HCV infection is strongly associated with the dysregulation of glucose homoeostasis such as insulin resistance (IR) and type 2 diabetes (T2D). Studies thus far and especially a recent retrospective study with 2435 patients have confirmed the relationship between HCV infection and T2D: People infected with HCV are 4 times more likely to develop T2D; clearance of HCV with direct‐acting antivirals significantly decreases HbA1c and the dependence on anti‐diabetes medications; and HCV‐infected patients with uncontrolled glucose are at higher risk to develop advanced liver fibrosis, HCC, and exhibit decreased sustained virologic response (SVR) to traditional interferon treatment.…”