Philip Weidner1, Dominik Boettche2, Thomas Zimmerer3, Elke Burgermeister2, Andreas Teufel2, Matthias P A Ebert2, Christoph Antoni2. 1. Dept. of Medicine II, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany. philip.weidner@umm.de. 2. Dept. of Medicine II, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany. 3. Clinic of Internal Medicine, Center of Gastroenterology, East-Tallinn Central Hospital, 10138 Tallinn, Estland.
Abstract
BACKGROUND AND AIM: With the development of direct acting antiviral agents (DAA) chronic hepatitis C virus (HCV) infection has become curable in most patients. Since HCV infection is known to have direct and/or indirect effects on glucose metabolism, successful HCV treatment may have an impact in reducing glucose level, pre-diabetes, the need of treatment for diabetes, and ultimately diabetes-associated morbidity. We investigated the association of DAA treatment and glucose metabolism in the context of development or resolution of hepatic fibrosis in a large cohort of HCV- infected patients. METHODS: In this retrospective single-center observational study, we investigated 281 patients receiving all-oral DAA therapy for fasting plasma glucose, HbA1c, liver enzymes and general clinical chemistry, measured during a 52-week follow-up. In addition, elastography, FIB-4- and APRI-calculation were used to assess hepatic fibrosis non-invasively. RESULTS: Successful elimination of HCV through DAA treatment was associated with a significant drop in fasting glucose level and a reduced rate of impaired fasting plasma glucose (FPG). Interestingly, this metabolic change was BMI-independent. In addition, long-term glucose levels also decreased after successful DAA treatment. A significant APRI-score reduction was associated with a persistent improvement of FPG. However, DAA did not have an impact on glucose metabolism in patients suffering from liver cirrhosis. CONCLUSION: This study highlights the beneficial impact of successful HCV therapy on glucose metabolism and identifies patients with liver cirrhosis as a collective in need of intensified surveillance with regard to diabetes progression despite HCV eradication.
BACKGROUND AND AIM: With the development of direct acting antiviral agents (DAA) chronic hepatitis C virus (HCV) infection has become curable in most patients. Since HCV infection is known to have direct and/or indirect effects on glucose metabolism, successful HCV treatment may have an impact in reducing glucose level, pre-diabetes, the need of treatment for diabetes, and ultimately diabetes-associated morbidity. We investigated the association of DAA treatment and glucose metabolism in the context of development or resolution of hepatic fibrosis in a large cohort of HCV- infectedpatients. METHODS: In this retrospective single-center observational study, we investigated 281 patients receiving all-oral DAA therapy for fasting plasma glucose, HbA1c, liver enzymes and general clinical chemistry, measured during a 52-week follow-up. In addition, elastography, FIB-4- and APRI-calculation were used to assess hepatic fibrosis non-invasively. RESULTS: Successful elimination of HCV through DAA treatment was associated with a significant drop in fasting glucose level and a reduced rate of impaired fasting plasma glucose (FPG). Interestingly, this metabolic change was BMI-independent. In addition, long-term glucose levels also decreased after successful DAA treatment. A significant APRI-score reduction was associated with a persistent improvement of FPG. However, DAA did not have an impact on glucose metabolism in patients suffering from liver cirrhosis. CONCLUSION: This study highlights the beneficial impact of successful HCV therapy on glucose metabolism and identifies patients with liver cirrhosis as a collective in need of intensified surveillance with regard to diabetes progression despite HCV eradication.
Authors: Riccardo Nevola; Luca Rinaldi; Letizia Zeni; Ferdinando C Sasso; Pia C Pafundi; Barbara Guerrera; Aldo Marrone; Mauro Giordano; Luigi E Adinolfi Journal: JGH Open Date: 2020-03-20
Authors: Pradeep Kumar Mada; Matthew E Malus; Arvin Parvathaneni; Bing Chen; Gabriel Castano; Sharon Adley; Maureen Moore; Michinari Hieda; Mohammed J Alam; Mark Feldman; John William King Journal: Int J Hepatol Date: 2020-01-13