Retrospective study of the associations between hepatitis C virus infection and metabolic factors

Yair-Sabag, Shira; Nussinson, Elchanan; Ben‐Assuli, Ofir; Shibli, Fahmi; Shahbari, Azmi; Zelber‐Sagi, Shira

doi:10.4254/wjh.v8.i30.1269

Cited by 5 publications

(7 citation statements)

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“…Larger amount of samples was included in our study than other studies [2, 14], which increased the statistical reliability of the results. Although the therapy agents in the study were no longer generally used for the treatment of HCV, the interferon and ribavirin combination therapy still plays an important role in certain limited resource settings.…”

Section: Discussionmentioning

confidence: 96%

“…Our results showed that the level of FBG in HCV group was higher than that in control group, which was consistent with other studies. Previous studies has revealed that HCV infection causes insulin resistance and glucose abnormalities even type 2 diabetes mellitus (T2DM) in susceptible individuals [11, 14]. Another long period follow-up study showed the cumulative incidence of T2DM in anti-HCV positive patients reached 14.3% while only 8.6% in seronegative individuals ( P < 0.0001) [15].…”

Section: Discussionmentioning

confidence: 99%

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The association of hepatitis c virus infection status with serum glucose levels

Wang

et al. 2019

BMC Gastroenterol

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Background Hepatitis C virus (HCV) infection is commonly associated with a disturbance of glucose metabolism. However, there have been conflicting reports on whether the clearance of the HCV may be followed by changes of serum blood glucose and insulin resistance. The aim of the present study was to evaluate the impact of HCV and antiviral treatment on serum glucose levels and other glucose metabolism parameters. Methods A retrospective analysis of 306 HCV-infected patients was performed. Fasting serum blood glucose (FBG) levels in these patients were compared with that of 325 healthy individuals. Serum parameters of glucose metabolism were measured in 183 patients with chronic hepatitis C at baseline, at the end of interferon α-2b plus ribavirin treatment, and at 24 weeks post-treatment. Results Patients with HCV infection had significantly higher FBG level than healthy controls (5.57 ± 0.74 vs. 5.11 ± 0.83 mmol/l, P < 0.001). After antiviral treatment, we found a significant reduction in FBG levels regardless of the outcome of treatment. However, after stopping treatment the serum FBG levels were significantly elevated in the sustained virological response (SVR) and non-responder groups, and maintained high level until week 24 post-treatment. In both groups, the levels of serum FBG after 24 weeks post-treatment were still lower than pre-treatment levels. In sustained responders, fasting insulin ( P = 0.007), C-peptide ( P < 0.001) and HOMA-IR ( P < 0.001) significantly decreased, and the insulin sensitivity index (ISI) increased ( P < 0.001) at the end of the treatment comparing with pre-treatment levels, while no significant difference was observed in non-responder group. HOMA-β values were increased in both groups at the end of treatment (both P < 0.001). Conclusion The total serum FBG level in HCV infected patients was higher than that in healthy controls. Clearance of HCV was associated with reduced glucose and improved insulin resistance.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

The association of hepatitis c virus infection status with serum glucose levels

Wang

et al. 2019

BMC Gastroenterol

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“…In a recently published study including 119 patients, Yair-Sabag et al, demonstrated a reduction in the incidence of T2DM in patients with SVR following peginterferon and ribavirin treatment. The same study did not identify any significant changes in MeS parameters before or after the treatment between responders and non-responders (27).…”

Section: Discussionmentioning

confidence: 80%

Metabolic Syndrome and Genotype 1 Virus C Compensated Liver Cirrhosis in the Era of Directly Acting Antiviral Therapy

et al. 2017

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Objectives: The current study aimed at evaluating the association between metabolic syndrome (MeS) in patients with hepatitis C virus (HCV) liver cirrhosis (compensated, genotype, 1b) and changes after sustained viral response (SVR) following a 12-week therapy with paritaprevir, ritonavir, ombitasvir, dasabuvir, and ribavirin (PrOD+R). Methods: The current multicenter retrospective study included 809 patients diagnosed with compensated HCV cirrhosis (child class A), all 1b genotype treated for 12 weeks with direct acting antiviral agents -PrOD+R -regimen (according to the protocol practiced in Romania) and achieved SVR. The parameters of MeS (according to the definition of the International Diabetes Federation) were collected from medical records before and 12 weeks after the treatment. The results were collected in a central database and analyzed with SPSS 18.0. Statistical analysis used both descriptive and analytical methods with a significance level of 95% (CI 95%). Results: Out of the 809 patients, 105 (13%) demonstrated 3 out of the 5 criteria for MeS. Based on the MeS criteria, the commonest parameters were abnormal glycaemia (54.1%), followed by visceral obesity (38.6%), raised triglycerides (26.1%), high blood pressure (12.1%), and a low high-density lipoprotein (HDL)-cholesterol (4.6%). The re-assessment of MeS parameters after SVR showed favourable changes, which were statistically significant: a siginficanttly lower serum triglyeride level (182.32 vs. 153.50 mg/dL, P = 0.001), lower systolic arterial blood pressure (130.57 vs. 124.85 mmHg; P = 0.001), lower diastolic arterial blood pressure (80.26 vs. 78.42 mmHg; P = 0.001) and lower glyceamic levels (130.06 vs. 120.71 mg/dL; P = 0.001), as well as a significant rise in HDL-cholesterol levels (48.61 vs. 50.50 mg/dL; P = 0.003). Abdominal circumference was the only parameter, which did not change after SVR. Following the changes sustained after SVR, 26.7% of the patients no longer fulfilled the minimum 3 criteria for MeS. No correlation was observed between the presence of MeS and the risk of severe adverse events, but it was noted that 37.5% of the patients who decompensated, 66.7% of the ones who developed hepatocarcinoma and 100% of the ones that died of abnormal glycaemic levels. Conclusions: Hyperglycemia, and not MeS, is associated with HCV compensated liver cirrhosis genotype 1b, and is a risk factor for severe adverse events. The attainment of SVR through PrOD+R regimen results in short-term improvements in MeS parameters.

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“…In contrast, HCV inhibits lipolysis by disturbing mito-chondrial β-oxidation[ 36 ], either directly by the virus itself or indirectly via downregulation of the enzyme carnitine palmitoyltransferase-1, which regulates fatty acids oxidation[ 37 , 38 ]. These two mechanisms further potentiated by HCV-induced IR[ 39 ]. Moreover, HCV core protein suppresses the activity of microsomal triacylglycerol transfer protein, which is used for the assembly and secretion of VLDL, resulting in increased intracytoplasmic lipid droplets and therefore steatosis[ 40 ].…”

Section: Hepatic Steatosismentioning

confidence: 99%

“…After achieving SVR with antiviral therapy, reversal of steatosis is the most common reported outcome, which was seen in several studies[ 17 , 27 , 28 , 39 ]. However, recent reviews showed contradictory findings[ 45 , 46 ].…”

Section: Hepatic Steatosismentioning

confidence: 99%

Metabolic and cardiovascular complications after virological cure in hepatitis C: What awaits beyond

Shengir¹,

Elgara²,

Sebastiani³

2021

WJG

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The association between chronic hepatitis C (CHC) infection and extrahepatic manifestations (EHMs), particularly cardiometabolic diseases, has been extensively examined. However, there has still been insufficient evaluation for these EHMs after virological cure. Several multidirectional mechanisms have been proposed explaining the ability of hepatitis C virus (HCV) developing EHMs, cardiometabolic ones, as well as the effect of antiviral therapy to resolve these EHMs. Data on these manifestations after achieving sustained virologic response (SVR) are still conflicting. However, current evidence suggests that reversal of hepatic steatosis and its coexistent hypocholesterolemia after successful viral eradication led to unfavorable lipid profile, which increases cardiovascular disease (CVD) risk. Additionally, most observations showed that metabolic alterations, such as insulin resistance and diabetes mellitus (DM), undergo some degree of reduction after viral clearance. These changes seem HCV-genotype dependent. Interferon-based antiviral therapy and direct acting antiviral drugs were shown to minimize incidence of DM. Large epidemiological studies that investigated the effect of SVR on CVD showed great discrepancies in terms of results, with predominant findings indicating that CVD events decreased in patients with SVR compared to non-responders or untreated ones. In this review, we present a summary of the current knowledge regarding extrahepatic sequelae of CHC following SVR, which may have an impact on healthcare providers’ clinical practice.

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Retrospective study of the associations between hepatitis C virus infection and metabolic factors

Cited by 5 publications

References 50 publications

The association of hepatitis c virus infection status with serum glucose levels

The association of hepatitis c virus infection status with serum glucose levels

Metabolic Syndrome and Genotype 1 Virus C Compensated Liver Cirrhosis in the Era of Directly Acting Antiviral Therapy

Metabolic and cardiovascular complications after virological cure in hepatitis C: What awaits beyond

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