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. 2021 Sep;41(9):2059-2067.
doi: 10.1111/liv.14905. Epub 2021 May 26.

Over time evaluation of glycaemic control in direct-acting antiviral-treated hepatitis C virus/diabetic individuals with chronic hepatitis or with cirrhosis

Irene Cacciola  1   2 , Giuseppina Russo  1   3 , Roberto Filomia  2 , Concetta Pitrone  1   2 , Gaia Caccamo  2 , Annalisa Giandalia  1   3 , Angela Alibrandi  4 , Maria Stella Franzè  1   2 , Serena Porcari  1   2 , Sergio Maimone  2 , Carlo Saitta  2 , Giovanni Squadrito  1   5 , Giovanni Raimondo  1   2
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Over time evaluation of glycaemic control in direct-acting antiviral-treated hepatitis C virus/diabetic individuals with chronic hepatitis or with cirrhosis

Irene Cacciola et al. Liver Int. 2021 Sep.

Abstract

Background: Data concerning the impact of hepatitis C virus (HCV) cure on type 2 diabetes mellitus (T2DM) are controversial. The aim of the study was to evaluate the effects of anti-HCV direct-acting antiviral (DAA) treatments on long-term glucose control in HCV/T2DM patients with chronic hepatitis C (CHC) or with cirrhosis.

Methods: One hundred and eighty-two consecutive HCV/T2DM patients who achieved a viral clearance by DAA treatment were enrolled. Seventy or 182 of them had CHC, and 112 had cirrhosis. Clinical, biochemical and instrumental parameters were recorded at baseline and at 48, 96 and 120 weeks (48w, 96w and 120w, respectively) after stopping DAA therapy.

Results: At baseline, the overall study population had a mean of glycated haemoglobin (HbA1c) value of 7.2% (ranging from 5 to 11.2), without any significant differences between CHC and cirrhosis [7.1 and 7.2, respectively]. Evaluation over time of HbA1c variations showed a significant improvement of glucose control at all post-treatment time points compared with baseline in CHC patients (P = .001). In cirrhotic patients, a significant decrease of HbA1c levels was only found when comparing HbA1c values between baseline and 48w time-point (P = .001), whereas this improvement disappeared at both 98w and 120w (P = .8 and P = .3, respectively). Multivariate logistic regression analysis showed that patients with chronic hepatitis have a 2.5 (CI 1.066-5.945) times greater chance of achieving an improvement of glycaemic values than patients with liver cirrhosis (P = .035).

Conclusion: DAA-based HCV cure induces a significant and persistent amelioration of glycaemic control in HCV/diabetic patients with chronic hepatitis, whereas cirrhotic HCV/diabetic subjects have only a transient benefit from the virus elimination.

Keywords: DAA therapies; HCV-related cirrhosis; chronic hepatitis C; glycated haemoglobin; type 2 diabetes mellitus.

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Conflict of interest statement

The authors declare they have no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Haemoglobin (HbA1c) level variations in respect to the baseline values at 48 (bold line), 96 (grey line) and 120 (dotted line) weeks after stopping direct‐acting antiviral (DAA) therapies in chronic hepatitis (A) and cirrhotic (B) patients, (P < .001 by Wilcoxon analysis)
FIGURE 2
FIGURE 2
Percentage of 70 patients with chronic hepatitis C (CHC) and 112 with cirrhosis showing haemoglobin (HbA1c) values < 7.2 g/dL at baseline, and at 48, 96 and 120 weeks after stopping direct‐acting antiviral (DAA) treatments
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References

    1. Soriano V, Young B, Reau N. Report from the international conference on viral hepatitis ‐ 2017. AIDS Rev. 2018;20(1):58‐70. - PubMed
    1. Negro F. Facts and fictions of HCV and comorbidities: steatosis, diabetes mellitus, and cardiovascular diseases. J Hepatol. 2014;61(1 Suppl):S69‐78. - PubMed
    1. Bugianesi E, Salamone F, Negro F. The interaction of metabolic factors with HCV infection: does it matter? J Hepatol. 2012;56(Suppl 1):S56‐65. - PubMed
    1. Fabiani S, Fortunato S, Bruschi F. Solid Organ transplant and parasitic diseases: a review of the clinical cases in the last two decades. Pathogens. 2018;7(3):65. - PMC - PubMed
    1. Desbois AC, Cacoub P. Diabetes mellitus, insulin resistance and hepatitis C virus infection: a contemporary review. World J Gastroenterol. 2017;23(9):1697‐1711. - PMC - PubMed

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