Hepatitis C virus eradication with direct-acting antiviral improves insulin resistance.
Aged
Antiviral Agents
/ therapeutic use
Cohort Studies
Diabetes Mellitus
/ prevention & control
Elasticity Imaging Techniques
Female
Hepacivirus
/ drug effects
Hepatitis C, Chronic
/ drug therapy
Humans
Insulin Resistance
Interferons
/ therapeutic use
Liver
/ diagnostic imaging
Male
Middle Aged
Prospective Studies
Sustained Virologic Response
Treatment Outcome
Diabetes
cirrhosis
direct-acting antivirals
hepatitis C virus
Journal
Journal of viral hepatitis
ISSN: 1365-2893
Titre abrégé: J Viral Hepat
Pays: England
ID NLM: 9435672
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
received:
09
05
2019
revised:
20
08
2019
accepted:
01
09
2019
pubmed:
10
10
2019
medline:
26
3
2021
entrez:
10
10
2019
Statut:
ppublish
Résumé
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 < .0001). SVR12 was achieved in 135 (98%) patients, and 124 (90%) patients reached the 48W post-EOT. At this time point, the percentage of patients with IR significantly decreased to 49% (P = 0,01). HOMA-IR was significantly lower than baseline (1.8 vs 3; P < .001), and this was related to a significant reduction of insulin level (11.7 ± 6.3 vs 16.4 ± 8.3). High BMI was associated with a significantly lower probability of achieving a non-IR status at 24W (P = .05) and 48W (P = .03).In conclusion, SVR following DAAs led to a significant reduction of IR, even in patients with cirrhosis. Nevertheless, IR can persist after the achievement of SVR, especially in patients with high BMI.
Substances chimiques
Antiviral Agents
0
Interferons
9008-11-1
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
188-194Informations de copyright
© 2019 John Wiley & Sons Ltd.
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