Treatment of type 2 diabetes mellitus by viral eradication in chronic hepatitis C: Myth or reality?

Dig Liver Dis. 2016 Feb;48(2):105-11. doi: 10.1016/j.dld.2015.10.016. Epub 2015 Oct 27.

Abstract

Chronic hepatitis C is a systemic disease inducing metabolic alterations leading to extrahepatic consequences. In particular, hepatitis C virus (HCV) infection seems to increase the risk of incident type 2 diabetes mellitus in predisposed individuals, independently of liver disease stage. The mechanisms through which hepatitis C induces T2DM involve direct viral effects, insulin resistance, pro-inflammatory cytokines and other immune-mediated processes. Many studies have reported the clinical consequences of type 2 diabetes mellitus on hepatitis C outcome, but very few studies have addressed the issue of microangiopathic complications among patients with hepatitis C only, who develop type 2 diabetes mellitus. Moreover, clinical trials in HCV-positive patients have reported improvement in glucose metabolism after antiviral treatment; recent studies have suggested that this metabolic amelioration might have a clinical impact on type 2 diabetes mellitus-related complications. These observations raise the question as to whether the HCV eradication may also have an impact on the future morbidity and mortality due to type 2 diabetes mellitus. The scope of this review is to summarise the current evidence linking successful antiviral treatment and the prevention of type 2 diabetes mellitus and its complications in hepatitis C-infected patients.

Keywords: Chronic hepatitis C; Diabetes mellitus; Hepatitis C virus; Impaired fasting glucose; Insulin resistance; Interferon; Microangiopathy; Ribavirin.

Publication types

  • Review

MeSH terms

  • Antiviral Agents / therapeutic use*
  • Blood Glucose / metabolism*
  • Cytokines / immunology*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / immunology
  • Diabetes Mellitus, Type 2 / metabolism*
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / epidemiology
  • Hepatitis C, Chronic / immunology
  • Hepatitis C, Chronic / metabolism
  • Humans
  • Insulin Resistance* / immunology
  • Liver / immunology*
  • Liver / metabolism
  • Treatment Outcome

Substances

  • Antiviral Agents
  • Blood Glucose
  • Cytokines