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Diabetes Impairs the Virological Response in Patients with Chronic Hepatitis B: Glycemic Control as a Key Modifiable
Aoyi Li1, Yan Han1, Guanglin Xiao1
1Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Department of Infectious Diseases, Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, Chongqing 401336, China.
Type 2 diabetes mellitus (T2DM) significantly reduces antiviral treatment effectiveness in chronic hepatitis B (CHB) patients. Achieving good glycemic control in CHB patients with T2DM can improve virological response rates.
Area of Science:
- Hepatology
- Endocrinology
- Virology
Background:
- Chronic hepatitis B (CHB) and type 2 diabetes mellitus (T2DM) often coexist, potentially impacting treatment outcomes.
- Understanding the interplay between T2DM, glycemic control, and antiviral therapy efficacy in CHB is crucial for patient management.
Purpose of the Study:
- To evaluate the influence of T2DM and glycemic control on the efficacy of nucleos(t)ide analogue (NA) therapy in CHB patients.
- To identify predictors of virological response in CHB patients treated with NAs.
Main Methods:
- Retrospective cohort study of treatment-naïve CHB patients initiating NA therapy (January 2019 - January 2024).
- Primary endpoint: Complete virological response (CVR) defined as HBV DNA < 20 IU/mL at 48 weeks.
- Comparison of CVR rates between CHB patients with and without T2DM, and analysis of factors influencing CVR within the T2DM subgroup.
Main Results:
- CHB patients with T2DM had significantly lower CVR rates (26.0%) compared to those without T2DM (41.2%).
- T2DM was identified as an independent negative predictor of CVR (OR = 0.400).
- Adequate glycemic control (HbA1c < 7%) in CHB + T2DM patients was associated with higher CVR (38.7% vs. 16.7%).
- Tenofovir-based regimens showed a more favorable antiviral trend than entecavir in CHB patients with T2DM.
Conclusions:
- Comorbid T2DM impairs antiviral efficacy in CHB patients treated with NAs.
- Optimal glycemic control is associated with improved virological outcomes in CHB patients with T2DM.
- Early diagnosis and management of T2DM may enhance antiviral treatment efficacy in CHB patients.
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