Effect of new direct-acting antiviral drugs on insulin resistance and glycemic control after treatment of chronic hepatitis C virus infection in type 2 diabetic patients

Hashim, Ahmed; Kandeel, Hanaa T; Hendy, Olfat; Elmola, Khaled; El-Raey, Fathyia M; Attia, Mohamed S.

doi:10.4103/azmj.azmj_7_18

Cited by 7 publications

(1 citation statement)

References 1 publication

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“…The study was conducted on 50 patients with T2DM and chronic HCV infection who were recruited from the outpatient clinics of the Health care facilities in El-Demerdash hospital and the National Research Center, depending on (Hashim et al, 2017) who found that the Mean±SD of HbA1c before and after HCV treatment were 7.11±0.88 and 6.77±0.98 respectively. And assuming the correlation between before and after levels was 0.500, power= 0.96 and α=0.05, and by using G*Power 3.1.9.4 release (Faul et al, 2009) the minimal sample size for a single group cohort study to detect a significant statistical change in HbA1c was found to be 49.…”

Section: Sample Sizementioning

confidence: 99%

Assessment of Hepatitis C management on glycemic control among Type 2 Diabetes Mellitus patients

et al. 2021

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Background: HCV and DM are chronic diseases of high global prevalence. Many studies proved the association between Hepatitis C and DM in the last three decades and this consists of an interrelated association; moreover, HCV infection triggers Diabetes Mellitus, most probably type 2. Objective: To assess the possibility of the improvement of T2DM in patients with HCV when applying the new DAA HCV treatment in Egypt. Patients and Methods:The current study is a prospective cohort hospital-based study that aims to describe the association between T2DM on one hand and chronic HCV on the other hand after successful management of HCV through the DAAs according to the protocol of the Ministry of Health. SVR was defined as undetectable HCV RNA levels at 12 weeks after the end of treatment (EOT). Fasting plasma glucose (FPG) levels between 100-125 mg/dL were defined as prediabetes and FPG ≥ 126 mg/dL was defined as diabetes. We have found positive correlation between management of HCV using DAAs in general and improvement of HbA1c and FPG. Moreover, we reported stronger correlation between achieving SVR and the HbA1c level and FPG. Results: After 12 weeks of follow-up, 82% of the patients maintained negative SVR, hemoglobin reduction was -0.6±0.4 %, 3 months after HCV treatment with a P value <0.001*. FPG reduction was -24.6±25.4 after 3 months of treatment with a P value of <0.001*. HbA1c reduction in patients with SVR was -0.8±0.2 % with a P value of <0.001*. No significant change in treatment choice was found during the period of study. Conclusion: Successful HCV eradication will result in a statistically significant reduction in fasting plasma glucose and HbA1c in patients with type 2 diabetes which is an indirect indicator of improvement of insulin sensitivity in patients with type 2 DM.

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Section: Sample Sizementioning

confidence: 99%

Assessment of Hepatitis C management on glycemic control among Type 2 Diabetes Mellitus patients

et al. 2021

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HCV infection characteristics, treatment uptake and outcomes in patient with diabetes mellitus

Angel

Petrosyan²,

Doyle³

et al. 2022

BMC Endocr Disord

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Background The interplay between HCV, DM, and DAA therapy is poorly understood. We compared HCV infection characteristics, treatment uptake, and treatment outcomes in patients with and without DM. Methods A retrospective cohort study was conducted using data from The Ottawa Hospital Viral Hepatitis Program. Statistical comparisons between diabetes and non-diabetes were made using χ2 and t-tests. Logistic regression analyses were performed to assess predictors of DM and SVR. Results One thousand five hundred eighty-eight HCV patients were included in this analysis; 9.6% had DM. Patients with DM were older and more likely to have cirrhosis. HCC and chronic renal disease were more prevalent in the DM group. Treatment uptake and SVR were comparable between groups. Regression analysis revealed that age and employment were associated with achieving SVR. Post-SVR HCC was higher in DM group. Conclusion The high prevalence of DM in our HCV cohort supports screening. Further assessment is required to determine if targeted, early DAA treatment reduces DM onset, progression to cirrhosis and HCC risk. Further studies are needed to determine if optimization of glycemic control in this population can lead to improved liver outcomes.

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Effect of eradication of HCV infection by direct-acting antivirals in diabetic HCV-infected patients as regards glycemic control

Badry

Ali

Eltaweel

et al. 2020

Egypt Liver Journal

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Background A burden of data suggests that insulin signaling could be impaired with hepatitis C virus infection, and this boost the onset of type 2 diabetes mellitus beyond and in addition to the histological effect on the associated liver disease. We aimed to evaluate the hemoglobin A1c (HbA1c) levels before and after therapy with direct-acting antivirals (DAAs) in HCV-diabetic patients who achieved sustained virological response (SVR) at Aswan Fever Hospital. This prospective study was conducted at the Viral Hepatitis Treatment Center, Aswan Fever Hospital, Aswan, Egypt, between November 2017 and May 2018. A total of 85 randomly selected diabetic patients (type 2 diabetes mellitus) with chronic HCV infection were received sofosbuvir and daclatasvir as a dual therapy for 3 months, then followed up for week 12 after the end of DAA therapy, Changes in the levels of hemoglobin A1c (HbA1c) were measured at baseline then 12 weeks after the end of treatment with DAAs. Results Thirty-two patients (37.6%) showed a significant glycemic improvement after receiving DAAs therapy; in the form of > 1% reduction in HbA1c level (p value < 0.001). Their baseline mean HbA1c level was 7.98 ± 0.62% which was significantly improved 12 weeks after the end of therapy (SVR) to reach a level of 6.88 ± 0.81%. Meanwhile, 53 patients (62.4%) had a baseline mean HbA1c of 8.24 ± 0.64% and a post-treatment mean HbA1c level of 8.34 ± 0.61% (p value = 0.083). Conclusion DAAs-based eradication of HCV is associated with improved glycemic control in 37.6% of patients with diabetes as evidenced by a significant reduction of mean HbA1c.

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Effect of new direct-acting antiviral drugs on insulin resistance and glycemic control after treatment of chronic hepatitis C virus infection in type 2 diabetic patients

Cited by 7 publications

References 1 publication

Assessment of Hepatitis C management on glycemic control among Type 2 Diabetes Mellitus patients

Assessment of Hepatitis C management on glycemic control among Type 2 Diabetes Mellitus patients

HCV infection characteristics, treatment uptake and outcomes in patient with diabetes mellitus

Effect of eradication of HCV infection by direct-acting antivirals in diabetic HCV-infected patients as regards glycemic control

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