Changes in Sustained Treatment Response in Relapsed Chronic Hepatitis C Egyptian Patients on Directly Acting Antiviral Agents with Increased Insulin Resistance | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 39, Volume 83, Issue 1, April 2021, Page 1056-1061 PDF (429.22 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2021.160616 | ||||
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| Authors | ||||
Inas Elkhedr Mohamed  1; Yasser Omar Abdel Rahman1; Ramy Samir Ghait1; Alaa Lotfy ElSayed2
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| 1Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Egypt. | ||||
| 2Kobri Alqoba Military Hospital, Egypt | ||||
| Abstract | ||||
| Background: It is known that patients with high insulin resistance (IR) have a slower rate of decline in the viral load of HCV RNA compared to patients with low IR. Objective: to evaluate relation between insulin resistance on sustained treatment response with direct oral antiviral drugs on relapsed Egyptian chronic HCV patients. Patients and Methods: 50 patients with chronic hepatitis C met inclusion criteria divided into Group I were non responders to treatment and achieved sustained virological response (SVR) at week 12 on retreatment and Group II were non responders to treatment and failed to attain SVR after 12 weeks of retreatment. All participants received the direct antiviral therapy (DAA) sofosbuvir and daclatasvir for 12 weeks. HOMA-IR was calculated and PCR was done before treatment, at end of treatment, 12 weeks and 3 months after end of treatment. Results: there was a highly significant correlation between HOMA-IR and liver enzymes, lipid (P<0.01) and significant relation between HOMA-IR and BMI and waist circumference. After 6 months of treatment there was highly significant increase in insulin sensitivity and decrease in insulin resistance in patients after eradication of HCV (P<0.01). 12 cases of insulin resistance pretreatment and after 6 months: 3 cases HCV -ve became non-insulin resistant, 2 cases HCV -ve became insulin resistant, 2 cases of HCV -ve developed DM and 5 cases had no changes (still insulin resistant). Conclusion: prevalence of insulin resistance and diabetes mellitus in patients with chronic hepatitis C was due to multiple causes and clearance of HCV infection improves insulin resistance; not directly related to DAA. | ||||
| Keywords | ||||
| Chronic hepatitis C; Directly acting antiviral agents; Insulin resistance; SVR | ||||
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