Effect of direct acting antiviral therapy of Chronic Hepatitis C virus on insulin resistance and Type2 DM in Egyptian patients (prospective study).

Background And Objectives: sustained virologic response (SVR) can be achieved in high percentage of HCV patients with the availability of direct acting antiviral agents DAAs. However, the effect of DAAs on insulin resistance and T2DM has yet to be clearly documented in spite of higher prevalence of T2DM in chronic HCV patients. This study tested the hypothesis that eradication of HCV is associated with either complete recovery or improvement of the symptoms of IR and T2DM.

Patients And Methods: In our study 240 Chronic HCV patients candidate to centers of NCCVH with Coordination to departments of internal medicine and clinical pathology, Zagzig University for treatment with DAAs. Measurement of HbA1c, FPG and fasting insulin hormone and calculation of HOMA-IR before and 3 months after DDAs therapy is done. Statistical analysis was done for these data.

Results: After SVR; HbA1c decreased from 7.6 ± 0.69 to 6.7 ± 0.78 in diabetic group and from 5.8 ± 0.5 to 5.1 ± 0.3 in non-diabetic group, with decreased in the percentage of uncontrolled T2DM patients from 22.4% to 5.2% after treatment. HOMA-IR decreased in diabetic group from 4.9 ± 0.7 to 3.7 ± 0.75 and in non-diabetic group from 3.1 ± 0.56 to 2.3 ± 0.4 with complete improvement of IR to ≤2.5 in 20.7% of diabetic patients. 20% of diabetic patient needed to decrease oral hypoglycemic dose and 13.3% of them needed to decrease insulin dose.

Conclusions: This study shows that eradication of HCV by DAAs will result in a parallel decrease in IR and improve clinical outcomes in patients with established T2DM.