HCV treatment with direct acting antivirals improves the insulin sensitivity

Expert Rev Anti Infect Ther. 2019 Sep;17(9):749-754. doi: 10.1080/14787210.2019.1653184. Epub 2019 Aug 17.

Abstract

Background: There is strong link between hepatitis C virus (HCV) infection and the insulin resistance panel. Homeostatic model assessment (HOMA) β is an indirect measurement of insulin secretion from pancreatic β cells, while HOMA-S accounts for insulin sensitivity. Aim: We examined the impact of HCV treatment with direct acting antivirals (DAAs) on HOMA-β and HOMA-S results. Methods: HOMA-IR, HOMA-β, and HOMA-S were calculated before and 12 weeks after treatment in 511 treatment eligible patients with HCV. Five DAA treatment protocols were used. Values before and after treatment were compared. Results: The mean age of patients was 50.63 years with a 3.2:1 male: female ratio. A total of 29.7% of patients were treatment experienced and 24.7% had diabetes. HCV sustained virological response (SVR) was achieved in 91% of patients. Unlike non-responders, SVR patients showed significantly decreased post-treatment HOMA-Β. Delta HOMA-Β was comparable between groups. HOMA-S increased significantly in patients with SVR compared to in non-responders, as did delta HOMA-S. HOMA-S and HOMA-β improved significantly under 5 and 2 DAA protocols, respectively. The treatment status did not affect the HOMA-β and S dynamics during treatment. Conclusions: Insulin sensitivity improved markedly in patients who achieved HCV SVR.

Keywords: Hepatitis C virus; direct acting antivirals; homeostatic model assessment for insulin resistance; homeostatic model assessment-S; homeostatic model assessment-β.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Antiviral Agents / administration & dosage*
  • Antiviral Agents / pharmacology
  • Female
  • Hepatitis C, Chronic / drug therapy*
  • Humans
  • Insulin Resistance*
  • Male
  • Middle Aged
  • Sustained Virologic Response
  • Treatment Outcome
  • Young Adult

Substances

  • Antiviral Agents