Impact of Treatment with Direct Acting Antiviral Drugs on Glycemic Control in Patients with Hepatitis C and Diabetes Mellitus

الملخص EN

Aim.

To assess the effect of treating chronic hepatitis C virus (HCV) infection with direct acting antiviral drugs (DAAs) on glycemic control in patients with concomitant diabetes mellitus (DM).

Methods.

We performed a retrospective case-control study in a viral hepatitis ambulatory clinic in Shreveport, Louisiana, during the period 11/01/2014 to 12/31/2017.

All the clinic patient ages 18 years and above with treatment-naïve/biopsy-proven chronic hepatitis C and DM (hemoglobin A1C level≥6.5%) who were eligible for treatment were included in the study.

Of 118 such patients, 59 were treated with oral DAAs for 8-12 weeks with the goal of achieving a sustained virologic response (SVR).

A control group of 59 patients did not receive treatment for their hepatitis C and was followed in the clinic.

Patients in the control group did not receive treatment either due to insurance issues or refusal of hepatitis C treatment.

Results.

Fifty-five of the 59 patients treated with DAAs (93%) achieved a SVR.

Six months after treatment completion, their mean±SEM HbA1C level had decreased by 1.1±0.03% (P<0.0001).

Four of the 59 patients treated with DAAs did not achieve a SVR.

Their mean HbA1C 6 months after treatment completion had increased by 0.8±0.2%.

Furthermore, there was no improvement in HbA1C levels over time in the untreated group (mean HbA1C increase, 0.2±0.05%; P<0.0001 vs.

the treatment group, which had a mean HbA1C decrease of 0.9±0.2%).

Conclusion.

This controlled study demonstrated that treatment of chronic hepatitis C with DAAs results in statistically significant and meaningful reductions in hemoglobin A1C levels in patients with coexisting diabetic mellitus if a SVR is achieved.