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Abstract Details
Impact of Treatment With Direct Acting Antiviral Drugs on Glycemic Control in Patients With Hepatitis C and Diabetes Mellitus
Int J Hepatol. 2020 Jan 13;2020:6438753. doi: 10.1155/2020/6438753. eCollection 2020.
Pradeep Kumar Mada12, Matthew E Malus3, Arvin Parvathaneni4, Bing Chen3, Gabriel Castano5, Sharon Adley2, Maureen Moore2, Michinari Hieda6, Mohammed J Alam2, Mark Feldman1, John William King2
Author information
1Internal Medicine Department, Texas Health Presbyterian Hospital, Dallas, TX, USA.
2Infectious Diseases, Louisiana State University Health Sciences Center-Shreveport, Shreveport, LA, USA.
3Internal Medicine, Louisiana State University Health Sciences Center-Shreveport, Shreveport, LA, USA.
4Neurology, Louisiana State University Health Sciences Center-Shreveport, Shreveport, LA, USA.
5Pediatrics, UT Health Sciences Center, San Antonio, USA.
6Institute for Exercise and Environmental Medicine, University of Texas Southwestern Medical Center, USA.
Free PMC article
Abstract
Aim: To assess the effect of treating chronic hepatitis C virus (HCV) infection with direct acting antiviral drugs (DAAs) on glycemic control in patients with concomitant diabetes mellitus (DM).
Methods: We performed a retrospective case-control study in a viral hepatitis ambulatory clinic in Shreveport, Louisiana, during the period 11/01/2014 to 12/31/2017. All the clinic patient ages 18 years and above with treatment-naïve/biopsy-proven chronic hepatitis C and DM (hemoglobin A1C level ≥ 6.5%) who were eligible for treatment were included in the study. Of 118 such patients, 59 were treated with oral DAAs for 8-12 weeks with the goal of achieving a sustained virologic response (SVR). A control group of 59 patients did not receive treatment for their hepatitis C and was followed in the clinic. Patients in the control group did not receive treatment either due to insurance issues or refusal of hepatitis C treatment.
Results: Fifty-five of the 59 patients treated with DAAs (93%) achieved a SVR. Six months after treatment completion, their mean ± SEM HbA1C level had decreased by 1.1 ± 0.03% (P < 0.0001). Four of the 59 patients treated with DAAs did not achieve a SVR. Their mean HbA1C 6 months after treatment completion had increased by 0.8 ± 0.2%. Furthermore, there was no improvement in HbA1C levels over time in the untreated group (mean HbA1C increase, 0.2 ± 0.05%; P < 0.0001 vs. the treatment group, which had a mean HbA1C decrease of 0.9 ± 0.2%).
Conclusion: This controlled study demonstrated that treatment of chronic hepatitis C with DAAs results in statistically significant and meaningful reductions in hemoglobin A1C levels in patients with coexisting diabetic mellitus if a SVR is achieved.