HCV treatment with direct acting antivirals improves the insulin sensitivity

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
• homeostatic model assessment-β
• homeostatic model assessment-S
• homeostatic model assessment for insulin resistance
• direct acting antivirals

Article highlights

• There is interplay between hepatitis C and the insulin panel.

• Insulin resistance is a common complication of hepatitis C and may impair the response to therapy.

• Most studies have focused on insulin resistance.

This study was conducted to assess the role of pancreatic secretion of insulin in patients with hepatitis C.

Declaration of interest

I Waked discloses being an Investigator and/or speaker for Abbvie, Gilead Sciences, Janssen, Marcyrl, Onxio, Pharco. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

All authors shared in data collection. Imam Waked and Hassan Elshenawy did conception of the design. Ayman Alsebaey, Mostafa Elhelbawy, Wael Abdel-Razek and Mohammed Hashim did the analysis and paper writing. Final revision was by Imam Waked and Ayman Alsebaey. All authors agreed to be accountable for all aspects of the work.

Additional information

Funding

This paper was not funded.