Chronic Hepatitis C Association with Diabetes Mellitus and Cardiovascular Risk in the Era of DAA Therapy

被引:48
|
作者
Drazilova, Sylvia [1 ]
Gazda, Jakub [2 ,3 ]
Janicko, Martin [2 ,3 ]
Jarcuska, Peter [2 ,3 ]
机构
[1] Hosp Poprad, Dept Internal Med, Poprad, Slovakia
[2] Safarik Univ, Fac Med, Dept Internal Med 1, Kosice, Slovakia
[3] L Pasteur Univ Hosp, Kosice, Slovakia
关键词
SUSTAINED VIROLOGICAL RESPONSE; ACTING ANTIVIRAL AGENTS; SERUM-LIPID PROFILES; VIRUS-INFECTION; INSULIN-RESISTANCE; GLUCOSE ABNORMALITIES; INTERFERON-ALPHA; GLYCEMIC CONTROL; PLUS RIBAVIRIN; HCV INFECTION;
D O I
10.1155/2018/6150861
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Patients with chronic hepatitis C have both higher prevalence of diabetes mellitus type 2 (T2DM) and increased cardiovascular risk compared to never infected people. Sustained viral response (SVR) achievement led to decreasing incidence and prevalence of T2DM during the interferon era of HCV treatment. Currently, direct-acting antiviral drugs (DAA) are the gold standard for treating HCV infection, while yielding SVR in nearly all patients. In chronic HCV patients with T2DM (prediabetes most likely too), DAA therapy is associated with both better fasting glucose and glycated hemoglobin (HbA1C) controls; thus reducing pharmacotherapy in a certain part of patients is possible. Papers mentioned in the review confirmed DAA role in both total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) increase. This alteration was accompanied by an increase in high-density lipoprotein cholesterol (HDL-C) and a decrease in triglycerides (TG) verified by most of the studies. However, the clinical significance of lipoprotein alterations caused by DAA therapy has not been explained yet. Moreover, DAA treatment of chronic hepatitis C improves hypertension control and atherosclerotic plaques. It is very likely that DAA therapeutic regimens will decrease both T2DM prevalence and cardiovascular risk in chronic hepatitis C patients; further research, however, is needed.
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页数:11
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