Impact of sustained virological response on the extrahepatic manifestations of chronic hepatitis C: a meta-analysis

Abstract

Antiviral therapy can reduce extrahepatic manifestations related to HCV when SVR is achieved. Higher quality data, and reporting over longer follow-up periods, will be required to thoroughly explore comprehensive HCV treatment strategies.

Systematic review: chronic viral hepatitis and metabolic derangement

“…In the era of DAA, the very high SVR rate causes doubt on whether insulin resistance could affect antiviral response. In contrast, insulin resistance significantly improved quickly when SVR is achieved . Additionally, for patients with T2DM, SVR leads to better glycaemic control at 12‐week post‐treatment than before DAA treatment is commenced .…”

“…Non‐SVR patients had a higher risk of de novo insulin resistance than SVR patients (17% vs 7%, P = .007). A meta‐analysis of the association of SVR with extrahepatic diseases of CHC revealed that SVR reduced the risk of insulin resistance at follow‐up (odds ratio: 0.42, 95% CI 0.33‐0.53) and had a significant protective effect against the incidence of new‐onset T2DM (odds ratio: 0.34, 95% CI 0.21‐0.56) . In the era of DAA, the very high SVR rate causes doubt on whether insulin resistance could affect antiviral response.…”

“…In contrast, insulin resistance significantly improved quickly when SVR is achieved. 160 Additionally, for patients with T2DM, SVR leads to better glycaemic control at 12-week post-treatment than before DAA treatment is commenced. 129,161,162 Dawood et al further indicated that 26.7%…”

Editorial: direct‐acting antivirals decrease the frequency of diabetes complications in patients with chronic hepatitis C

“…However, association between SVR and HCV‐metabolic complications remains unclear. A meta‐analysis from Cacoub et al revealed that SVR was associated with decreased extrahepatic mortality, reduced insulin resistance and decreased incidence of diabetes.…”

Expanded benefits of curing the extrahepatic manifestations of HCV infection

“…In Gut , Cacoub and collaborators4 report a systematic review—supported by a rigorous assessment of data quality—of published articles evaluating the effect of treatment-induced viral clearance on HCV-associated EHM. Based on published evidence, a sustained virological response (SVR) was found to be associated with an ~50% reduction in HCV-related extrahepatic mortality.…”