Impact of direct acting antiviral (DAA) treatment on glucose metabolism and reduction of pre-diabetes in patients with chronic hepatitis C

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 re...

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Bibliographische Detailangaben
Hauptverfasser: Weidner, Philip (VerfasserIn) , Böttche, Dominik (VerfasserIn) , Burgermeister, Elke (VerfasserIn) , Teufel, Andreas (VerfasserIn) , Ebert, Matthias (VerfasserIn) , Antoni, Christoph Helmer (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2018
In: Journal of gastrointestinal and liver diseases
Year: 2018, Jahrgang: 27, Heft: 3, Pages: 281-289
ISSN:1842-1121
Online-Zugang: Volltext
Verfasserangaben:Philip Weidner, Dominik Boettche, Thomas Zimmerer, Elke Burgermeister, Andreas Teufel, Matthias P.A. Ebert, Christoph Antoni

MARC

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520 |a 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. 
650 4 |a Antiviral Agents 
650 4 |a Biomarkers 
650 4 |a Blood Glucose 
650 4 |a Drug Therapy, Combination 
650 4 |a Female 
650 4 |a Germany 
650 4 |a Glycated Hemoglobin A 
650 4 |a Hepatitis C, Chronic 
650 4 |a Humans 
650 4 |a Liver 
650 4 |a Liver Cirrhosis 
650 4 |a Male 
650 4 |a Middle Aged 
650 4 |a Prediabetic State 
650 4 |a Retrospective Studies 
650 4 |a Risk Factors 
650 4 |a Time Factors 
650 4 |a Treatment Outcome 
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