TY  - JOUR
A1  - Graf, Christiana
A1  - Welzel, Tania Mara
A1  - Bogdanou, Dimitra
A1  - Vermehren, Johannes
A1  - Beckel, Anita
A1  - Bojunga, Jörg
A1  - Friedrich-Rust, Mireen
A1  - Dietz, Julia
A1  - Kubesch, Alica
A1  - Mondorf, Antonia Maria
A1  - Fischer, Sarah
A1  - Lutz, Thomas
A1  - Stoffers, Philipp Clemens
A1  - Herrmann, Eva
A1  - Poynard, Thierry
A1  - Zeuzem, Stefan
A1  - Dultz, Georg
A1  - Mihm, Ulrike
T1  - Hepatitis C clearance by direct-acting antivirals impacts glucose and lipid homeostasis
T2  - Journal of Clinical Medicine
N2  - 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.
KW  - hepatitis C virus
KW  - hepatic fibrosis
KW  - insulin resistance
KW  - direct-acting antivirals
Y1  - 2020
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/55588
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-555886
SN  - 2077-0383
VL  - 9
IS  - (9), article 2702
PB  - MDPI
CY  - Basel
ER  -