The Effect of Hepatitis C Virus Eradication with New Direct Acting Antivirals on Glucose Homeostasis in Non-Diabetic Egyptian Patients

Shehab-Eldin, Walid; Nada, Ali; Abdulla, Azza M.; Shehab-Eldeen, Somaia

doi:10.4172/2155-6156.1000766

Cited by 4 publications

(4 citation statements)

References 22 publications

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“…As a consequence of the reduction in IR, several studies showed an increase in insulin sensitivity, expressed as an increase in HOMA‐S 61,63,68,69 . Patients with baseline IR showed an improvement in beta‐cell function with greater amelioration in glycemic control after SVR, 70 while nondiabetic patients did not reveal a significant change in beta‐pancreatic cell function 71 …”

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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“…In addition, the effect of HCV modulating the metabolic pathways of intrahepatic cholesterol biosynthesis to promote viral replication can generate significant changes in lipid metabolism in SVR 2 . However, positive and negative metabolic changes were described with treatment with DAAs 11 , 19 , and a better understanding of this issue is necessary in different populations.…”

Section: Discussionmentioning

confidence: 99%

Effects of hepatitis C virus genotypes and viral load on glucose and lipid metabolism after sustained virological response with direct-acting antivirals

Sparvoli

Pereira

et al. 2023

Rev. Assoc. Med. Bras.

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SUMMARY OBJECTIVE: The objective of this study, carried out at the university hospital of the Federal University of Rio Grande, was to assess whether the treatment of chronic hepatitis C with direct-acting antivirals and the sustained virological response will affect the metabolic influences of the hepatitis C virus and whether these effects will vary according to genotypes and virus load. METHODS: This is an intervention pre-post study, carried out from March 2018 to December 2019, evaluating 273 hepatitis C virus patients treated with direct-acting antivirals. Inclusion criteria included being monoinfected with hepatitis C virus and achieving sustained virological response . Exclusion criteria included the presence of decompensated cirrhosis or co-infected with hepatitis B virus or human immunodeficiency virus. Genotypes, genotype 1 subtypes, and hepatitis C virus viral load were analyzed. Glucose metabolism was evaluated by the Homeostasis Model Assessment-insulin resistance indices: Homeostasis Model Assessment-β, TyG, and HbA1c, measured at the beginning of treatment and in sustained virological response. Statistical analysis with a T test by paired comparison of the means of the variables in the pretreatment and in the sustained virological response. RESULTS: Homeostasis Model Assessment-insulin resistance analysis: there were no significant differences between pretreatment and sustained virological response. Homeostasis Model Assessment-β analysis: significant increase in genotype 1 patients (p<0.028). TyG index analysis: significant increase in genotype 1b (p<0.017), genotype 3 (p<0.024), and genotype non-1 with low viral load (p<0.039). HbA1c analysis: significant decrease in genotype 3 (p<0.001) and genotype non-1 patients with low viral load (p<0.005). CONCLUSION: We detected significant metabolic influences after sustained virological response: impairment in lipid profile and improvements in the glucose metabolism. We found significant differences in genotype dependence, genotype 1 subtypes, and viral load.

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“…Additionally, a study by Shehab-Eldin and cols. ( 18 ) found that SVR with DAAs improves glycemic control, with a reduction in fasting glucose at the end of treatment. The authors explained that this finding reflected an improvement in β cell function, as HCV could directly inhibit insulin secretion, which would improve after virus eradication.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, it is plausible to expect that therapies to eradicate HCV, by reducing inflammation, may improve metabolic parameters and reduce the rate of T2DM and IR in patients with chronic HCV infection ( 14 ). However, conflicting results regarding the possible metabolic improvement from the use of DAAs emphasize the importance of establishing the effect of SVR on the glucose metabolism of these patients ( 18 ). Therefore, this study aimed to compare the glucose metabolism of patients with chronic HCV infection treated with direct-acting antivirals in the pretreatment and SVR periods.…”

Section: Introductionmentioning

confidence: 99%

Impact of hepatitis C virus eradication with direct-acting antivirals on glycidic metabolism

Sparvoli¹,

Sparvoli²,

Dumith³

et al. 2022

Archives of Endocrinology and Metabolism

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Objective: To compare the glucose metabolism of patients with chronic hepatitis C virus infection treated with direct-acting antivirals (DAAs) in pretreatment and sustained viral response (SVR) periods. Materials and methods: This was an intervention pre-post study of 273 patients with chronic hepatitis C virus infection treated with DAAs from March 2018 to December 2019. Glycidic metabolism was evaluated through homeostasis model assessment (HOMA) -insulin resistance (IR) and HOMA-β indices and assessments of insulinemia and HbA1c levels. These parameters were analyzed with a T test by paired comparison of the means of the variables and Wilcoxon's test paired for the median; in the variables with an abnormal distribution, the Z score was generated for the mean in both the pretreatment and SVR periods. Statistical significance was considered at p ≤ 0.05. Results: Among 273 participants, 125 (45.8%) had prediabetes, and 50 (18.3%) had diabetes. In SVR, there was a significant increase in platelets, albumin, alkaline phosphatase, cholesterol and triglycerides and a significant decrease in aspartate aminotransferase, alanine aminotransferase, gamma GT and bilirubin. The HOMA-IR and HOMA-β indices increased in SVR from 1.95 to 2.29 (p = 0.087) and 71.20 to 82.60 (p = 0.001), respectively. Insulinemia increased from 7.60 μU/mL to 8.90 μU/mL (p = 0.011). HbA1c decreased from 5.6 to 5.4 (p < 0.001). Among patients with prediabetes and those with diabetes, the reduction in HbA1c values was significant (p = 0.006 and p = 0.026, respectively). Conclusion: SVR significantly impacts and leads to improvement in glucose metabolism in patients with chronic liver disease induced by hepatitis C virus.

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The Effect of Hepatitis C Virus Eradication with New Direct Acting Antivirals on Glucose Homeostasis in Non-Diabetic Egyptian Patients

Abstract: Introduction: Chronic hepatitis C (HCV) infection and Diabetes Mellitus (DM) are common health problems in Egypt. HCV treatment by the new Direct Acting Antiviral (DAA) drugs gives hope to eradicate HCV. However, its effect on glucose homeostasis is not studied.

Cited by 4 publications

References 22 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

Effects of hepatitis C virus genotypes and viral load on glucose and lipid metabolism after sustained virological response with direct-acting antivirals

Impact of hepatitis C virus eradication with direct-acting antivirals on glycidic metabolism

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