Impact of Direct-Acting Antiviral Treatment on Glucose Metabolism in Patients with Chronic Hepatitis C Virus Infection

Introduction: An association between hepatitis C virus (HCV) infection and type 2 diabetes mellitus (DM2) or insulin resistance has been reported. Curing HCV chronic infection with interferon is associated with an improvement in various hepatic and metabolic parameters. The treatment of HCV infection has recently been revolutionized by the development of direct-acting antiviral agents (AADs), which have a high probability of sustained HCV elimination. The main aim of this study is to analyze the impact of DAA treatment on glucose metabolism in patients with chronic HCV infection and DM2/pre-diabetes. Material and methods: This study included 138 patients who underwent virus eradication with DAA between 1/1/2015 and 31/8/2019. We evaluated data for sample characterization, including HCV infection, liver and metabolic status related data. Results: Fifty four patients (39.1%) had impaired glucose metabolism. Following viral clearance, there was a significant improvement in liver fibrosis (p=0.001), significant reduction in ALT (p<0.001), AST (p<0.001) and GGT (p 0.001) and fasting glucose (p<0.001). Initial fibrosis was negatively correlated with tasting glucose variation after treatment (p = 0.032). We could not find any predictors of improved glycemic control. Conclusion: In this study, there was an improvement in glycemic control after the cure of HCV infection, as well as normalization of analytical liver parameters and regression of hepatic fibrosis. Prospective studies should be performed to assess the sustainability of these improvements and identify possible predictors of improved metabolic control.