Hepatitis C virus eradication with direct‐acting antiviral improves insulin resistance

Sustained virological response (SVR) after interferon‐based therapy is associated with improvement of insulin resistance (IR) in HCV‐infected patients. Few data are available in the direct‐acting antivirals (DAAs) era, especially in cirrhotic patients. We prospectively evaluated the long‐term effect...

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Bibliographic Details
Published in:Journal of viral hepatitis 2020-02, Vol.27 (2), p.188-194
Main Authors: Russo, Francesco Paolo, Zanetto, Alberto, Gambato, Martina, Bortoluzzi, Ilaria, Al Zoairy, Ramona, Franceschet, Enrica, De Marchi, Federica, Marzi, Luca, Lynch, Erica Nicola, Floreani, Annarosa, Farinati, Fabio, Schaefer, Benedikt, Burra, Patrizia, Zoller, Heinz, Mega, Andrea
Format: Article
Language:English
Subjects:
Aged
Antiviral agents
Antiviral Agents - therapeutic use
Cirrhosis
Cohort Studies
Diabetes
Diabetes mellitus
Diabetes Mellitus - prevention & control
direct‐acting antivirals
Disease resistance
Elasticity Imaging Techniques
Female
Hepacivirus - drug effects
Hepatitis C
hepatitis C virus
Hepatitis C, Chronic - drug therapy
Homeostasis
Humans
Insulin
Insulin Resistance
Interferon
Interferons - therapeutic use
Liver - diagnostic imaging
Liver - virology
Liver cirrhosis
Male
Middle Aged
Prospective Studies
Sustained Virologic Response
Treatment Outcome
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Summary:Sustained virological response (SVR) after interferon‐based therapy is associated with improvement of insulin resistance (IR) in HCV‐infected patients. Few data are available in the direct‐acting antivirals (DAAs) era, especially in cirrhotic patients. We prospectively evaluated the long‐term effect of DAAs on IR. Patients treated with DAAs between May 2015 and December 2016 in 3 tertiary care centres were recruited. Patients with diabetes were excluded. Biochemical and virological data were collected at baseline, 12/24/48 weeks (W) after the end of therapy (EOT). Presence of IR was defined by a ‘homeostasis model assessment index for IR’ [HOMA‐IR])> 2.5. Liver fibroscan was performed at baseline, at 24/48W after EOT. Hundred and thirty‐eight patients were enrolled (mean age 58 years, M/F 85/53, GT1 61%, 68.8% cirrhotic). Sixty‐eight patients (94/138) had IR. Patients with IR had significantly higher stiffness than patients without it (23 ± 12 vs 15 ± 8; P 
ISSN:1352-0504
1365-2893
DOI:10.1111/jvh.13215