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Virus Elimination by Direct-Acting Antiviral Agents Impacts Glucose Homeostasis in Chronic Hepatitis C Patients

Chun-Han Cheng1,2, Chia-Ying Chu3, Huan-Lin Chen1,2

  • 1Division of Gastroenterology, Department of Internal Medicine, Taitung Mackay Memorial Hospital, Taitung, Taiwan.

Frontiers in Endocrinology
|January 31, 2022
PubMed

Insights

Direct-acting antiviral agents (DAAs) can improve insulin resistance (IR) in some patients with chronic hepatitis C virus (HCV) infection. Key factors for IR include obesity and advanced liver fibrosis, with improvements seen post-HCV elimination.

Area of Science:

  • Hepatology
  • Endocrinology
  • Virology

Background:

  • Chronic hepatitis C virus (HCV) infection is linked to glucose metabolism issues like insulin resistance (IR) and type 2 diabetes.
  • Independent risk factors for IR in HCV patients require further clarification.
  • Data on HCV elimination's impact on glucose homeostasis using direct-acting antiviral agents (DAAs) is limited and conflicting.

Purpose of the Study:

  • To identify independent risk factors for IR in chronic HCV patients.
  • To assess changes in glucose homeostasis after HCV eradication with DAAs.

Main Methods:

  • Screened 704 patients with chronic HCV treated with interferon-free DAAs.
  • Collected baseline characteristics, biochemical, and virological data.
  • Assessed IR and beta-cell function using homeostasis model assessment (HOMA) at baseline and 12 weeks post-treatment.

Main Results:

  • 35.1% of patients had high IR (HOMA-IR ≥ 2.5).
  • Independent IR predictors included BMI >25 kg/m², prior treatment, high ALT/triglycerides, and Fibrosis-4 score >3.25.
  • Sustained virological response (SVR) significantly reduced HOMA-IR in patients with baseline high IR, HCV genotype 1, and prior treatment experience.

Conclusions:

  • Obesity, prior treatment, high ALT/triglycerides, and advanced fibrosis are independent IR factors in chronic HCV.
  • DAA therapy led to significant HOMA-IR reduction in specific subgroups, indicating potential metabolic benefits post-HCV cure.
Abstract

Keywords:
direct-acting antiviral agentsgenotypehepatitis Chomeostasis model assessmentinsulin resistancetype 2 dabetes

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