Effect of treatment with direct acting antiviral on glycemic control in patients with diabetes mellitus and chronic hepatitis C



Título del documento: Effect of treatment with direct acting antiviral on glycemic control in patients with diabetes mellitus and chronic hepatitis C
Revista: Annals of hepatology
Base de datos: PERIÓDICA
Número de sistema: 000409342
ISSN: 1665-2681
Autores: 1
1
1
1
1
1
Instituciones: 1University of Virginia, School of Medicine, Charlottesville, Virginia. Estados Unidos de América
Año:
Periodo: Mar-Abr
Volumen: 16
Número: 2
Paginación: 215-220
País: México
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Experimental
Resumen en inglés The effect of the new direct acting antiviral drugs (DAAs) for chronic hepatitis C (HCV) on glycemic control is unknown. Materials and methods. We conducted a retrospective cohort study of patients who were treated for chronic HCV with direct-acting antiviral medications at a single academic institution between May 2013 and April 2016. Univariate analysis was performed comparing subjects pre and post-treatment. Results. One hundred seventy-five consecutive adult patients were treated for chronic HCV and met enrollment criteria. The majority (80.8%) were genotype 1 and overall cohort sustained virologic response at week 12 (SVR12) was 97.8%. Thirty-one (18.5%) had diabetes mellitus (DM); twenty-six had pre and post-treatment HbA1c values. Of these, 76.9% were male and 61.5% had cirrhosis. Ninety-six percent were prescribed sofosbuvir-based therapy and all but one (96.8%) achieved SVR12. Three patients were started on treatment despite meeting the definition for poorly controlled DM (HbA1c > 9 mg/dL). There was no significant difference when comparing pre-treatment (7.36 mg/dL, 95% CI 6.55-8.16) to post-treatment HbA1c (7.11 mg/dL, 95% CI 6.34-7.88, p = 0.268). Thirty-one percent of subjects required dose escalation or the initiation of insulin based therapy during treatment. Discussion. Although chronic HCV is associated with exacerbation of insulin resistance, our results showed HbA1c to be unaffected by eradication of chronic HCV with DAA in diabetic patients with and without cirrhosis. Paradoxically, almost 1/3 of patients required escalation of anti-diabetic therapy during treatment. Long-term studies are warranted to understand the relationship between HCV viral eradication and insulin metabolism
Disciplinas: Medicina
Palabras clave: Gastroenterología,
Metabolismo y nutrición,
Microbiología,
Hepatitis C,
Hepatitis crónica,
Cirrosis,
Hipertensión portal,
Viremia,
Insulina,
Diabetes
Keyword: Medicine,
Gastroenterology,
Metabolism and nutrition,
Microbiology,
Hepatitis C,
Chronic hepatitis,
Cirrhosis,
Portal hypertension,
Viremia,
Insulin,
Diabetes
Texto completo: Texto completo (Ver PDF)