Effect of direct-acting antiviral drugs for hepatitis C virus on hepatic fibrosis and glycemic control in type 2 diabetes mellitus

Abstract

General background Hepatitis C virus (HCV) is a major cause of chronic liver disease, resulting in end-stage liver disease and hepatocellular carcinoma. Diabetes mellitus (DM) is a chronic metabolic disorder characterized by persistent hyperglycemia. Not only does HCV increases type 2 diabetes mellitus (T2DM) risk but it also worsens its control and is associated with increased prevalence of diabetes complications. There is interacting relationship between HCV, T2DM, and the degree and severity of liver fibrosis (FIB) and that T2DM is potentially preventable or controllable by curing HCV infection. Our study aimed to evaluate the effect of eradication of HCV by direct-acting antivirals on the glycemic control, indicated by glycated hemoglobin, and liver FIB, indicated by FIB-4 score. Patients and methods We enrolled in our study 200 patients with chronic hepatitis C (with compensated liver function) and T2DM, who were treated with direct-acting antiviral drugs for 12 weeks, and we followed up their fasting blood sugar, glycated hemoglobin %, and FIB-4 score at the beginning of treatment, at the end of treatment, and then after 3 months. Results Overall, 95% of the patients achieved sustained virological response (SVR) and 5% did not (NSVR). Moreover, 80% from SVR achieved improved glycemic control versus only 10% in NSVR. On the contrary, 80.5% of SVR exhibited decrease (improvement) in FIB-4 score versus 70% in NSVR, but the reduction of FIB-4 was more significant in SVR group. Moreover, there was a statistically significant relationship between improved glycemic control and improvement of FIB-4 score. Conclusion Eradication of HCV was significantly associated with improvement of glycemic control and FIB-4 score. Improvement of glycemic control occurred along with improvement of FIB-4 score after eradication of HCV.