Glycemic control after initiating direct-acting antiviral agents in patients with hepatitis C virus and type 2 diabetes mellitus using the united states integrated healthcare system

Wong, Angela; Sie, John; Chen, Angela; Gunawan, Basuki; Chung, Joanie; Rashid, Nazia

doi:10.4103/jrpp.jrpp_19_110

Cited by 7 publications

(3 citation statements)

References 14 publications

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“…The independent predictors of glycemic amelioration in diabetic patients appear to be higher baseline HbA1c (>7%), viral eradication with DAAs, higher baseline alanine aminotransferase (ALT), lower aspartate aminotransferase (AST), and older age 62,75,83–86 . Conversely, higher fibrosis stage before treatment, longer T2DM duration, a positive family history of diabetes, the Child class B, and the oesophageal varices were associated with lower improvement of glycemic control 75,78,85,87 .…”

Section: Resultsmentioning

confidence: 99%

Effect of HCV eradication by DAAs on liver steatosis, carotid atherosclerosis, and associated metabolic comorbidities: A systematic review

Cespiati,

Coelho Rodrigues,

Santos

et al. 2024

Liver International

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Background and AimsThe beneficial effect of Hepatitis C virus (HCV) eradication by direct antiviral agents (DAAs) on liver fibrosis is well defined. Despite this, the impact of viral eradication in both hepatic and extra‐hepatic metabolic features is underreached. This systematic review aimed to synthesize the evidence on the impact of HCV eradication by DAAs on liver steatosis, carotid atherosclerosis, glucidic impairment, dyslipidaemia, and weight gain.MethodsA systematic search of the existing literature (up to December 2022) identified 97 original studies that fulfilled the inclusion criteria.ResultsWhereas total cholesterol and low‐density lipoprotein (LDL) seem to increase after viral eradication, the cardiovascular damage expressed as carotid plaques and intima‐media thickness seems to improve. Otherwise, the effect on liver steatosis, glucidic homeostasis, and weight seems to be strictly dependent on the presence of baseline metabolic disorders.ConclusionDespite high heterogeneity and relatively short follow‐up of included studies, we can conclude that the presence of metabolic risk factors should be strictly evaluated due to their impact on liver steatosis, glucidic and lipid homeostasis, and on weight gain to better identify patients at risk of liver disease progression despite the virus eradication.

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Section: Resultsmentioning

confidence: 99%

Effect of HCV eradication by DAAs on liver steatosis, carotid atherosclerosis, and associated metabolic comorbidities: A systematic review

Cespiati,

Coelho Rodrigues,

Santos

et al. 2024

Liver International

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“…However, recent data suggested a direct role of HCV [172] by inducing death of pancreatic beta cells and upregulating several hepatokines known to cause insulin resistance. Achieving SVR by DAAs is associated with a reduced incidence of DM and a significant improvement in glycemic control among diabetic patients [93,[173][174][175][176][177] (Table 2, [178][179][180][181][182][183][184][185][186][187]). Moreover, this beneficial effect seems to have a clinical impact on DM-related complications [161].…”

Section: Diabetes Mellitusmentioning

confidence: 99%

Therapy of Chronic Viral Hepatitis: The Light at the End of the Tunnel?

2022

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Chronic viral hepatitis determines significant morbidity and mortality globally and is caused by three main etiological actors (Hepatitis B Virus, Hepatitis C Virus, and Hepatitis D Virus) with different replicative cycles and biological behaviors. Thus, therapies change according to the different characteristics of the viruses. In chronic hepatitis B, long term suppressive treatments with nucleoside/nucleotide analogues have had a dramatic impact on the evolution of liver disease and liver-related complications. However, a conclusive clearance of the virus is difficult to obtain; new strategies that are able to eradicate the infection are currently objects of research. The therapy for Hepatitis D Virus infection is challenging due to the unique virology of the virus, which uses the synthetic machinery of the infected hepatocyte for its own replication and cannot be targeted by conventional antivirals that are active against virus-coded proteins. Recently introduced antivirals, such as bulevertide and lonafarnib, display definite but only partial efficacy in reducing serum HDV-RNA. However, in combination with pegylated interferon, they provide a synergistic therapeutic effect and appear to represent the current best therapy for HDV-positive patients. With the advent of Direct Acting Antiviral Agents (DAAs), a dramatic breakthrough has occurred in the therapeutic scenario of chronic hepatitis C. Cure of HCV infection is achieved in more than 95% of treated patients, irrespective of their baseline liver fibrosis status. Potentially, the goal of global HCV elimination by 2030 as endorsed by the World Health Organization can be obtained if more global subsidised supplies of DAAs are provided.

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“…Hum et al and Wong et al discovered that individuals with type 2 DM had better glycemic control when HCV was eradicated with direct acting antiviral (DAA) medications (3,6) .…”

Section: Introductionmentioning

confidence: 99%

Insulin Resistance and Related Glycemic Parameters in Type 2 Diabetes Mellitus after Successful Treatment of HCV

Elsayed¹,

ELAMAWY

Ibrahim³

2023

The Egyptian Journal of Hospital Medicine

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Background: Chronic hepatitis C virus infection is a worldwide health problem that could cause complications such as cirrhosis or even hepatocellular carcinoma. Hepatitis C virus (HCV) infection has increased preponderance of diabetes mellitus (DM) type 2 and insulin resistance. Objectives: Our goal is to determine whether the most recent direct acting antiviral (DAA) medications for the HCV treatment are linked to improvements in insulin resistance and other related glycemic parameters in type 2 DM patients. Patients and Methods: This prospective, observational study was conducted on 40 diabetic patients aged >18 years treated from HCV by DAA. Baselines HCV PCR and liver function tests were obtained before DAA. Pre-and post-treatment change of the glycemic profile including calculated homeostatic model assessment of insulin resistance (HOMA-IR) lab results were taken. Results: Impact of DDA drugs on our subjects' glycemic profile showed improvements of all glycemic indices (Fasting plasma glucose (FPG), fasting insulin, HBA1c and HOMA-IR with p-value < 0.001. HCV PCR changes after treatment was positivity correlated significantly especially with FPG and HOMA-IR (r value 0.501 and 0.478 respectively) with pvalue < 0.05. Conclusion:We concluded that DAAs improved insulin resistance and related glycemic control parameters after eradication of HCV. Our results suggest that HCV take a part in glucose homeostasis. Liver function before treatment could be a predictor of improvement of insulin resistance.IR, Diabetes Mellites, Direct Acting Antiviral DAA -HCV, HOMA

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Glycemic control after initiating direct-acting antiviral agents in patients with hepatitis C virus and type 2 diabetes mellitus using the united states integrated healthcare system

Cited by 7 publications

References 14 publications

Effect of HCV eradication by DAAs on liver steatosis, carotid atherosclerosis, and associated metabolic comorbidities: A systematic review

Effect of HCV eradication by DAAs on liver steatosis, carotid atherosclerosis, and associated metabolic comorbidities: A systematic review

Therapy of Chronic Viral Hepatitis: The Light at the End of the Tunnel?

Insulin Resistance and Related Glycemic Parameters in Type 2 Diabetes Mellitus after Successful Treatment of HCV

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