Hepatitis C Clearance by Direct-Acting Antivirals Impacts Glucose and Lipid Homeostasis - Sorbonne Université Access content directly
Journal Articles Journal of Clinical Medicine Year : 2020

Hepatitis C Clearance by Direct-Acting Antivirals Impacts Glucose and Lipid Homeostasis

Christiana Graf
  • Function : Author
Tania Welzel
  • Function : Author
Dimitra Bogdanou
  • Function : Author
Johannes Vermehren
  • Function : Author
Anita Beckel
  • Function : Author
Jörg Bojunga
  • Function : Author
Mireen Friedrich-Rust
  • Function : Author
Julia Dietz
  • Function : Author
Alica Kubesch
Antonia Mondorf
  • Function : Author
Sarah Fischer
  • Function : Author
Thomas Lutz
  • Function : Author
Philipp Stoffers
  • Function : Author
Eva Herrmann
  • Function : Author
Georg Dultz
  • Function : Author
Ulrike Mihm
  • Function : Author

Abstract

Background: Chronic hepatitis C virus (HCV) infections are causally linked with metabolic comorbidities such as insulin resistance, hepatic steatosis, and dyslipidemia. However, the clinical impact of HCV eradication achieved by direct-acting antivirals (DAAs) on glucose and lipid homeostasis is still controversial. The study aimed to prospectively investigate whether antiviral therapy of HCV with DAAs alters glucose and lipid parameters. Methods: 50 patients with chronic HCV who were treated with DAAs were screened, and 49 were enrolled in the study. Biochemical and virological data, as well as noninvasive liver fibrosis parameters, were prospectively collected at baseline, at the end of treatment (EOT) and 12 and 24 weeks post-treatment. Results: 45 of 46 patients achieved sustained virologic response (SVR). The prevalence of insulin resistance (HOMA-IR) after HCV clearance was significantly lower, compared to baseline (5.3 ± 6.1 to 2.5 ± 1.9, p < 0.001), which is primarily attributable to a significant decrease of fasting insulin levels (18.9 ± 17.3 to 11.7 ± 8.7; p = 0.002). In contrast to that, HCV eradication resulted in a significant increase in cholesterol levels (total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein (HDL-C) levels) and Controlled Attenuated Score (CAP), although BMI did not significantly change over time (p = 0.95). Moreover, HOMA-IR correlated significantly with noninvasive liver fibrosis measurements at baseline und during follow-up (TE: r = 0.45; p = 0.003, pSWE: r = 0.35; p = 0.02, APRI: r = 0.44; p = 0.003, FIB-4: r = 0.41; p < 0.001). Conclusion: Viral eradication following DAA therapy may have beneficial effects on glucose homeostasis, whereas lipid profile seems to be worsened.

Dates and versions

hal-03974765 , version 1 (06-02-2023)

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Christiana Graf, Tania Welzel, Dimitra Bogdanou, Johannes Vermehren, Anita Beckel, et al.. Hepatitis C Clearance by Direct-Acting Antivirals Impacts Glucose and Lipid Homeostasis. Journal of Clinical Medicine, 2020, 9 (9), pp.2702. ⟨10.3390/jcm9092702⟩. ⟨hal-03974765⟩
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