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Background and aim <p>Limited data on the effects of direct-acting antiviral (DAA) drugs on glycemic control and lipid profiles in chronic hepatitis C (CHC) patients with type 2 diabetes mellitus (T2DM).</p> Methods <p>One hundred fifty-one treatment-naïve CHC patients with T2DM, not on insulin and with no prior diagnosis of hyperlipidemia, were treated with Sofosbuvir 400mg and Daclatasvir 60mg for 12 weeks. Laboratory tests included fasting blood sugar (FBG), hemoglobinA1c (HbA1c), fasting insulin, Homeostasis Model Assessment for Insulin Resistance (HOMA-IR), low-density lipoprotein (LDL), total cholesterol, and triglycerides.</p> Results <p>Mean age 50.6 ± 5.6 years, 53% females. Significant baseline hyperlipidemia when compared to control group of 150 non diabetic CHC: total cholesterol (207.5 ± 31.6 vs 162 ± 24.1 mg/dL; <i>p</i> &lt; 0.001), LDL (129.6 ± 18.2 vs 115.1 ± 9.2 mg/dL; <i>p</i> = 0.009) and triglycerides (177.6 ± 40.6 vs 151 ± 31.5 mg/dL; <i>p</i> = 0.02); with sustained virologic response (SVR) of 98.7 and 100%, respectively. Diabetic group patients who achieved SVR had significant improvements in labs after 12 weeks of treatment: FBG (137.9 ± 18.1 vs 113.3 ± 11.5 mg/dL; <i>p</i> &lt; 0.001), HbA1C (8.3 ± 2.1 vs 6.5 ± 1.5; <i>p</i> &lt; 0.001), fasting insulin (16.1 ± 2.1 vs 10.4 ± 2.3 µIU/mL; <i>p</i> &lt; 0.001), HOMA-IR (5.4 ± 0.8 vs 2.8 ± 0.6; <i>p</i> &lt; 0.001), total cholesterol (207.5 ± 31.6 vs 174.7 ± 28.2; <i>p</i> &lt; 0.001), LDL (129.6 ± 18.2 vs 105.9 ± 16.2; <i>p</i> &lt; 0.001) and triglycerides (177.6 ± 40.6 vs 142.9 ± 41.1; <i>p</i> = 0.004).</p> Conclusion <p>Diabetes negatively impacts lipid levels but does not reduce the high cure success rate of DAAs. Significant improvements in glycemic control, insulin resistance, and lipid profiles were observed in patients who achieved SVR, suggesting that HCV clearance in diabetic patients may enhance glucose and lipid homeostasis.</p>

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Impact of Sofosbuvir/Daclatasvir treatment on glycemic control and lipid profile in diabetic patients with chronic hepatitis C

  • 期刊论文

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  • 发表日期：

    2025年7月10日

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  • Tamer Fouad,
  • Ahmed Abd Elraouf,
  • Hassan Elshenawy,
  • Gamal Badra,
  • Heba Abd Allah,
  • Ahmed Attia

摘要

Background and aim

Limited data on the effects of direct-acting antiviral (DAA) drugs on glycemic control and lipid profiles in chronic hepatitis C (CHC) patients with type 2 diabetes mellitus (T2DM).

Methods

One hundred fifty-one treatment-naïve CHC patients with T2DM, not on insulin and with no prior diagnosis of hyperlipidemia, were treated with Sofosbuvir 400mg and Daclatasvir 60mg for 12 weeks. Laboratory tests included fasting blood sugar (FBG), hemoglobinA1c (HbA1c), fasting insulin, Homeostasis Model Assessment for Insulin Resistance (HOMA-IR), low-density lipoprotein (LDL), total cholesterol, and triglycerides.

Results

Mean age 50.6 ± 5.6 years, 53% females. Significant baseline hyperlipidemia when compared to control group of 150 non diabetic CHC: total cholesterol (207.5 ± 31.6 vs 162 ± 24.1 mg/dL; p < 0.001), LDL (129.6 ± 18.2 vs 115.1 ± 9.2 mg/dL; p = 0.009) and triglycerides (177.6 ± 40.6 vs 151 ± 31.5 mg/dL; p = 0.02); with sustained virologic response (SVR) of 98.7 and 100%, respectively. Diabetic group patients who achieved SVR had significant improvements in labs after 12 weeks of treatment: FBG (137.9 ± 18.1 vs 113.3 ± 11.5 mg/dL; p < 0.001), HbA1C (8.3 ± 2.1 vs 6.5 ± 1.5; p < 0.001), fasting insulin (16.1 ± 2.1 vs 10.4 ± 2.3 µIU/mL; p < 0.001), HOMA-IR (5.4 ± 0.8 vs 2.8 ± 0.6; p < 0.001), total cholesterol (207.5 ± 31.6 vs 174.7 ± 28.2; p < 0.001), LDL (129.6 ± 18.2 vs 105.9 ± 16.2; p < 0.001) and triglycerides (177.6 ± 40.6 vs 142.9 ± 41.1; p = 0.004).

Conclusion

Diabetes negatively impacts lipid levels but does not reduce the high cure success rate of DAAs. Significant improvements in glycemic control, insulin resistance, and lipid profiles were observed in patients who achieved SVR, suggesting that HCV clearance in diabetic patients may enhance glucose and lipid homeostasis.