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Hepatitis C Clearance by Direct-Acting Antivirals Impacts Glucose and Lipid Homeostasis

Background: Chronic hepatitis C virus (HCV) infections are causally linked with metabolic comorbidities such as insulin resistance, hepatic steatosis, and dyslipidemia. However, the clinical impact of HCV eradication achieved by direct-acting antivirals (DAAs) on glucose and lipid homeostasis is sti...

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Autores principales: Graf, Christiana, Welzel, Tania, Bogdanou, Dimitra, Vermehren, Johannes, Beckel, Anita, Bojunga, Jörg, Friedrich-Rust, Mireen, Dietz, Julia, Kubesch, Alica, Mondorf, Antonia, Fischer, Sarah, Lutz, Thomas, Stoffers, Philipp, Herrmann, Eva, Poynard, Thierry, Zeuzem, Stefan, Dultz, Georg, Mihm, Ulrike
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564474/
https://www.ncbi.nlm.nih.gov/pubmed/32825571
http://dx.doi.org/10.3390/jcm9092702
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author Graf, Christiana
Welzel, Tania
Bogdanou, Dimitra
Vermehren, Johannes
Beckel, Anita
Bojunga, Jörg
Friedrich-Rust, Mireen
Dietz, Julia
Kubesch, Alica
Mondorf, Antonia
Fischer, Sarah
Lutz, Thomas
Stoffers, Philipp
Herrmann, Eva
Poynard, Thierry
Zeuzem, Stefan
Dultz, Georg
Mihm, Ulrike
author_facet Graf, Christiana
Welzel, Tania
Bogdanou, Dimitra
Vermehren, Johannes
Beckel, Anita
Bojunga, Jörg
Friedrich-Rust, Mireen
Dietz, Julia
Kubesch, Alica
Mondorf, Antonia
Fischer, Sarah
Lutz, Thomas
Stoffers, Philipp
Herrmann, Eva
Poynard, Thierry
Zeuzem, Stefan
Dultz, Georg
Mihm, Ulrike
author_sort Graf, Christiana
collection PubMed
description Background: Chronic hepatitis C virus (HCV) infections are causally linked with metabolic comorbidities such as insulin resistance, hepatic steatosis, and dyslipidemia. However, the clinical impact of HCV eradication achieved by direct-acting antivirals (DAAs) on glucose and lipid homeostasis is still controversial. The study aimed to prospectively investigate whether antiviral therapy of HCV with DAAs alters glucose and lipid parameters. Methods: 50 patients with chronic HCV who were treated with DAAs were screened, and 49 were enrolled in the study. Biochemical and virological data, as well as noninvasive liver fibrosis parameters, were prospectively collected at baseline, at the end of treatment (EOT) and 12 and 24 weeks post-treatment. Results: 45 of 46 patients achieved sustained virologic response (SVR). The prevalence of insulin resistance (HOMA-IR) after HCV clearance was significantly lower, compared to baseline (5.3 ± 6.1 to 2.5 ± 1.9, p < 0.001), which is primarily attributable to a significant decrease of fasting insulin levels (18.9 ± 17.3 to 11.7 ± 8.7; p = 0.002). In contrast to that, HCV eradication resulted in a significant increase in cholesterol levels (total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein (HDL-C) levels) and Controlled Attenuated Score (CAP), although BMI did not significantly change over time (p = 0.95). Moreover, HOMA-IR correlated significantly with noninvasive liver fibrosis measurements at baseline und during follow-up (TE: r = 0.45; p = 0.003, pSWE: r = 0.35; p = 0.02, APRI: r = 0.44; p = 0.003, FIB-4: r = 0.41; p < 0.001). Conclusion: Viral eradication following DAA therapy may have beneficial effects on glucose homeostasis, whereas lipid profile seems to be worsened.
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spelling pubmed-75644742020-10-26 Hepatitis C Clearance by Direct-Acting Antivirals Impacts Glucose and Lipid Homeostasis Graf, Christiana Welzel, Tania Bogdanou, Dimitra Vermehren, Johannes Beckel, Anita Bojunga, Jörg Friedrich-Rust, Mireen Dietz, Julia Kubesch, Alica Mondorf, Antonia Fischer, Sarah Lutz, Thomas Stoffers, Philipp Herrmann, Eva Poynard, Thierry Zeuzem, Stefan Dultz, Georg Mihm, Ulrike J Clin Med Article Background: Chronic hepatitis C virus (HCV) infections are causally linked with metabolic comorbidities such as insulin resistance, hepatic steatosis, and dyslipidemia. However, the clinical impact of HCV eradication achieved by direct-acting antivirals (DAAs) on glucose and lipid homeostasis is still controversial. The study aimed to prospectively investigate whether antiviral therapy of HCV with DAAs alters glucose and lipid parameters. Methods: 50 patients with chronic HCV who were treated with DAAs were screened, and 49 were enrolled in the study. Biochemical and virological data, as well as noninvasive liver fibrosis parameters, were prospectively collected at baseline, at the end of treatment (EOT) and 12 and 24 weeks post-treatment. Results: 45 of 46 patients achieved sustained virologic response (SVR). The prevalence of insulin resistance (HOMA-IR) after HCV clearance was significantly lower, compared to baseline (5.3 ± 6.1 to 2.5 ± 1.9, p < 0.001), which is primarily attributable to a significant decrease of fasting insulin levels (18.9 ± 17.3 to 11.7 ± 8.7; p = 0.002). In contrast to that, HCV eradication resulted in a significant increase in cholesterol levels (total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein (HDL-C) levels) and Controlled Attenuated Score (CAP), although BMI did not significantly change over time (p = 0.95). Moreover, HOMA-IR correlated significantly with noninvasive liver fibrosis measurements at baseline und during follow-up (TE: r = 0.45; p = 0.003, pSWE: r = 0.35; p = 0.02, APRI: r = 0.44; p = 0.003, FIB-4: r = 0.41; p < 0.001). Conclusion: Viral eradication following DAA therapy may have beneficial effects on glucose homeostasis, whereas lipid profile seems to be worsened. MDPI 2020-08-21 /pmc/articles/PMC7564474/ /pubmed/32825571 http://dx.doi.org/10.3390/jcm9092702 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Graf, Christiana
Welzel, Tania
Bogdanou, Dimitra
Vermehren, Johannes
Beckel, Anita
Bojunga, Jörg
Friedrich-Rust, Mireen
Dietz, Julia
Kubesch, Alica
Mondorf, Antonia
Fischer, Sarah
Lutz, Thomas
Stoffers, Philipp
Herrmann, Eva
Poynard, Thierry
Zeuzem, Stefan
Dultz, Georg
Mihm, Ulrike
Hepatitis C Clearance by Direct-Acting Antivirals Impacts Glucose and Lipid Homeostasis
title Hepatitis C Clearance by Direct-Acting Antivirals Impacts Glucose and Lipid Homeostasis
title_full Hepatitis C Clearance by Direct-Acting Antivirals Impacts Glucose and Lipid Homeostasis
title_fullStr Hepatitis C Clearance by Direct-Acting Antivirals Impacts Glucose and Lipid Homeostasis
title_full_unstemmed Hepatitis C Clearance by Direct-Acting Antivirals Impacts Glucose and Lipid Homeostasis
title_short Hepatitis C Clearance by Direct-Acting Antivirals Impacts Glucose and Lipid Homeostasis
title_sort hepatitis c clearance by direct-acting antivirals impacts glucose and lipid homeostasis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564474/
https://www.ncbi.nlm.nih.gov/pubmed/32825571
http://dx.doi.org/10.3390/jcm9092702
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