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Diabetes mellitus, insulin resistance and hepatitis C virus infection: A contemporary review

World Journal of GastroenterologyDesbois AC, et al. | March 16, 2017

This research intends to summarise the literature data on hepatitis C virus (HCV)–infected patients concerning the prevalence of glucose abnormalities and associated risk. The authors reveal a strong association between glucose abnormalities with HCV infection and show a negative impact on the main liver–related outcomes.

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Methods

  • In this study, the authors conducted a PubMed search and selected all studies found with the keywords "HCV" or "hepatitis C virus" and "diabetes" or "insulin resistance".
  • Only comparative studies written in English or in French were included, published from January 2000 to April 2015.
  • For this study, they collected the literature data on HCV-infected patients regarding the prevalence of glucose abnormalities [diabetes mellitus (DM) and insulin resistance (IR)] and associated risk [i.e., severe liver fibrosis, response to antivirals, and the occurrence of hepatocellular carcinoma (HCC)].

Results

  • Compared with healthy volunteers and patients with hepatitis B virus infection, HCV infection is significantly associated with DM/IR.
  • Glucose abnormalities were correlated with advanced liver fibrosis, lack of sustained virologic response to interferon alfa-based treatment and with a higher risk of HCC development.
  • As new antiviral therapies may offer a cure for HCV infection for liver and non-liver consequences of HCV disease such data should be taken into account, from a therapeutic and preventive point of view.
  • By some studies, the efficacy of antidiabetic treatment in improving the response to antiviral treatment and in decreasing the risk of HCC has been reported, but not by others.
  • Therefore, the effects of glucose abnormalities correction in reducing liver events require further studies.

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