Glycemic Control in Patients Undergoing Treatment With Paritaprevir/Ombitasvir/Ritonavir and Dasabuvir for Chronic Hepatitis C Infection

Abstract

Background/Aim: Patients with hepatitis C virus (HCV)-associated cirrhosis are more prone to developing type 2 diabetes mellitus than patients with any other etiology of cirrhosis. The main objective of this study was to evaluate the impact of all oral antiviral treatment with ritonavir-boosted paritaprevir/ombitasvir and dasabuvir (OBV/PTV/r + DSV) in patients with chronic genotype 1b HCV infection. Patients and Methods: We retrospectively evaluated 806 patients who underwent antiviral therapy between December 2015 and July 2019. The laboratory data analyzed were liver function tests, kidney function tests, HCV viremia, fasting glucose levels, and glycosylated hemoglobin. Results: Patients with impaired glucose metabolism were predominantly male and of older age compared to patients with normal glucose tolerance, and also had higher levels of transaminases. Proteinuria and higher creatinine levels were found in patients with impaired glucose metabolism. Overall, we found a 98.01% rate of sustained virologic response (SVR), with a non-significant difference between patients with normal and abnormal glucose metabolism. A statistically significant difference in SVR rates in patients with low degrees of fibrosis (F0-F2) versus those with advanced degrees of fibrosis (F3-F4) was found in both groups. Antiviral treatment resulted in significant decreases in fasting glucose levels and glycosylated hemoglobin levels in all patients with impaired glucose metabolism at SVR. Conclusion: Patients with pre-diabetes, as well as diabetic patients, achieved a better glycemic control after SVR obtained by ritonavir-boosted paritaprevir/ombitasvir and dasabuvir.

Influência de polimorfismos no gene MTTP nos níveis de lipídeos e na esteatose associada à infecção crônica pelo vírus da hepatite C

“…Recentemente, níveis séricos elevados de GGT foram associados a um risco aumentado de síndrome metabólica avaliado entre 5.960 adultos coreanos (Kwak;Seo;Lee, 2023) e, também, foram associados a um risco aumentado de diabetes (Li et al, 2022). Bacinschi et al (2022) avaliaram pacientes com hepatite C crônica e observaram níveis elevados de GGT em pacientes com alteração no metabolismo da glicose (Bacinschi et al, 2022). Se a GGT é de fato um fator de risco para fatores metabólicos e resistência à insulina ainda precisa ser investigado e esclarecido.…”