scholarly journals OUTCOME OF ERADICATION OF CHRONIC HEPATITIS C VIRUS INFECTION WITH DIRECT ACTING ANTIVIRAL AGENTS ON BLOOD SUGAR CONTROL AND INSULIN RESISTANCE IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

2018 ◽  
Vol 47 (2) ◽  
pp. 241-256
Author(s):  
Arafat Kassem ◽  
Mabrouk Mahmoud Aboelenin ◽  
Mohamed Abdelhamid Khedr
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Antiviral Agents ◽  
Hepatitis C Virus Infection ◽  
Direct Acting Antiviral ◽  
Chronic Hepatitis C Virus ◽  
Direct Acting ◽  
Direct Acting Antiviral Agents

scholarly journals The Effect of Viral Clearance Achieved by Direct-Acting Antiviral Agents on Hepatitis C Virus Positive Patients with Type 2 Diabetes Mellitus: A Word of Caution after the Initial Enthusiasm

2020 ◽  
Vol 9 (2) ◽  
pp. 563 ◽  
Author(s):  
Davide Giuseppe Ribaldone ◽  
Marco Sacco ◽  
Giorgio Maria Saracco
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Hepatitis C ◽  
Antiviral Agents ◽  
Clinical Impact ◽  
Direct Acting Antiviral ◽  
Direct Acting ◽  
Direct Acting Antiviral Agents

The causal link between chronic hepatitis C and glycometabolic alterations has been confirmed by much biochemical, clinical, and epidemiological research work, but what is still controversial is the long-term clinical impact of sustained virologic response (SVR) achieved by direct-acting antiviral agents (DAAs) on patients with type 2 diabetes mellitus (DM). The aim of this paper is to summarize the biochemical and clinical consequences to DM of DAA-based therapy for hepatitis C virus (HCV) infection. An electronic search of Embase, PubMed, MEDLINE, Ovid, and the Cochrane Database of Systematic Reviews was conducted for publications assessing whether clearance of HCV achieved by interferon (IFN)-free antiviral therapy determines significant changes in glycometabolic control and clinical outcomes of diabetic patients. A beneficial effect of SVR obtained by DAA therapy on DM prevention and the short-term outcome of glycometabolic alterations are acknowledged by most of the studies. Whether this effect is maintained over the long term with a significant clinical impact on diabetic and liver disease is still a matter of debate.

scholarly journals Impact of Direct-acting Antiviral Agents on Glycometabolism in Chronic Hepatitis C Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Bing Li ◽  
Qinglei Zeng ◽  
Qian Wang ◽  
Hongyi Li ◽  
Xiaoli Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Antiviral Agents ◽  
Direct Acting Antiviral ◽  
Direct Acting ◽  
Direct Acting Antiviral Agents

Background and aims: The type 2 diabetes mellitus (T2DM) is a common comorbidity of chronic hepatitis C (CHC). This study intended to investigate the impact of direct-acting antiviral agents (DAAs)-induced sustained virological response (SVR) on glycometabolism in CHC patients with T2DM. Methods: We searched PubMed, Scopus, Web of Science, and Embase up to July 7th, 2021. Studies reporting the association between DAA-induced SVR and glycometabolism in diabetic patients were retained. Changes in glycated hemoglobin (HbA1c) and fasting plasma glucose (FPG) levels before DAA treatment and after SVR were conducted meta-analyses with random-effects models. Results: 1371 potentially relevant articles were screened. Our analysis included 16 studies with data for 5024 patients. A significant improvement was noted in glycemic control in SVR group, with a mean HbA1c reduction of 0.57% (95% CI: 0.46–0.69%; I=72.8%) and FPG reduction of 22.28mg/dL (95% CI: 13.35–31.21mg/dL; I=96.18%). Conversely, changes of HbA1c in non-SVR group were a mean increase of 0.03% (95% CI: -0.15–0.22%; I=68.75%). Subgroup analyses about HbA1c and FPG classified by study type both showed decline of the two indicators after SVR, and especially a reduction of HbA1c, 0.52% (95% CI: 0.39–0.65%; I=73.5%) in retrospective study subgroup and 0.70% (95% CI: 0.54–0.87%; I=36.15%) in prospective study subgroup, indicating lower heterogeneity in prospective studies. Egger’s test suggested publication bias in impact of DAAs on FPG, and no publication bias in impact on HbA1c. Sensitivity analyses confirmed robustness of the results. Conclusion: The glyco-metabolic control improved in terms of HbA1c and FPG level after DAA-induced SVR. However, further large and well-designed prospective cohort studies are still warranted and a prolonged follow-up is needed.

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