Walid Shehab-Eldin, Ali Nada, Azza Abdulla and Somaia Shehab Eldeen
Introduction: Chronic hepatitis C (HCV) infection and Diabetes Mellitus (DM) are common health problems in Egypt. HCV treatment by the new Direct Acting Antiviral (DAA) drugs gives hope to eradicate HCV. However, its effect on glucose homeostasis is not studied.
Aim: Study of glucose homeostasis before and after treatment of HCV infected patients with DAA drugs.
Subjects and methods: Eighty patients chronically infected with HCV, diagnosed by quantitative PCR, were subjected to physical examination and anthropometric measurements. In addition, FBS, fasting insulin, CBC, bilirubin, AST, ALT, Serum Albumin and serum creatinine were assessed at the beginning of the study. HOMA-IR, β cell %, BMI and e GFR were calculated. All patients received DAA drugs ± ribavirin for 3 months. All parameters were reassessed at End of Treatment (EOT).
Results: FBS, Hb, AST, ALT and Platelet count were reduced at EOT. Serum bilirubin, fasting insulin and HOMAIR were significantly increased at EOT. No significant difference as regarding body weight, serum creatinine, e GFR or β cell function. Correlation between insulin resistance at EOT with all basal and EOT measurements showed only a significant positive correlation with basal bilirubin.
Conclusion: Although eradication of HCV by DAA drugs improves glycemic control, it is associated with increased IR. Basal serum bilirubin can predict the development of IR. However, this predictive value is lost with viral eradication by DAA.