Improvement of glycemic state among responders to Sofosbuvir-based treatment regimens: Single center experience

J Med Virol. 2017 Dec;89(12):2181-2187. doi: 10.1002/jmv.24897. Epub 2017 Aug 10.

Abstract

Chronic HCV infection has emerged as a complex multifaceted disease with manifestations extending beyond the liver. HCV plays a direct role in glucose metabolism leading to both insulin resistance and type 2 diabetes. To evaluate the changes in the glycemic state following Sofosbuvir-based treatment regimens in diabetic HCV patients. Four hundred chronic hepatitis C patients who underwent Sofosbuvir-based treatment regimens were retrospectively screened. Sixty-five diabetic HCV patients only enrolled in our analysis. Baseline demographic and laboratory data were recorded. Pretreatment Transient elastography was performed. At 24-week post EOT (SVR24), Fasting Plasma glucose, and Hemoglobin A1c were re-evaluated and compared with baseline. All enrolled diabetic patients were responders. They showed statistically significant decline in Fasting Plasma glucose and Hemoglobin A1c values at SVR24. Whatever the degree of hepatic fibrosis, the level of Fasting Plasma glucose and Hemoglobin A1c decreased at SVR24 in comparison to baseline level. Fifty-one patients showed improvement in their Hemoglobin A1c values at SVR24 and this improvement was more likely to occur among patients with low Body mass index. The reduction in Fasting Plasma glucose >20 mg/dL (>1.1 mmol/L) and Hemoglobin A1c ≥0.5% was not associated with age, gender or hepatic fibrosis stage. Sofosbuvir-based regimens are a highly efficient antiviral therapy for diabetic chronic HCV patients resulted in improvement in Fasting Plasma glucose and Hemoglobin A1c.

Keywords: Hemoglobin A1c; chronic hepatitis C virus; diabetes mellitus; fasting plasma glucose.

MeSH terms

  • Aged
  • Antiviral Agents / adverse effects
  • Antiviral Agents / therapeutic use*
  • Blood Glucose / analysis
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications*
  • Egypt / epidemiology
  • Female
  • Glycated Hemoglobin / analysis
  • Glycemic Index / drug effects*
  • Hepacivirus / drug effects
  • Hepatitis C, Chronic / complications*
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / epidemiology
  • Humans
  • Insulin Resistance
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / virology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Ribavirin / therapeutic use
  • Sofosbuvir / administration & dosage
  • Sofosbuvir / adverse effects
  • Sofosbuvir / therapeutic use*

Substances

  • Antiviral Agents
  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human
  • Ribavirin
  • Sofosbuvir