Sustained Virological Response to HCV Therapy Improves Outcomes for Patients With Diabetes

Investigators found that extrahepatic outcomes are improved for patients with hepatitis C and type 2 diabetes having a sustained virological response, as a result of treatment with either interferon-based or direct-acting antivirals.

For patients with type 2 diabetes and hepatitis C virus (HCV) infection, successful HCV treatment significantly reduces the risk for acute coronary syndrome, end-stage renal disease, ischemic stroke, and retinopathy, regardless of cirrhosis, according to results published in Alimentary Pharmacology & Therapeutics.

The study included participants from 4 US health systems in the Chronic Hepatitis Cohort Study who had HCV along with type 2 diabetes, and who were receiving antidiabetic medications (n=1395). The researchers followed participants until an outcome of interest, death, or last health system encounter. They estimated the effect of treatment on outcomes using the competing risk analysis (Fine-Gray subdistribution hazard ratio [sHR]) with death as a competing event.

Of all the participants, 52% (n=723) were treated with either interferon-based or direct-acting antivirals (DAAs). Of these, 75% (n=540) achieved sustained virological response (SVR).

The researchers found that compared with participants who were not treated for HCV, participants who achieved SVR had significantly decreased risks for

  • acute coronary syndrome (sHR, 0.36; P <.001),
  • end-stage renal disease (sHR, 0.46; P <.001),
  • stroke (sHR, 0.34; P <.001), and
  • retinopathy (sHR, 0.24; P <.001).

These results remained consistent in subgroup analyses of participants who were treated with DAA and those treated with interferon. The researchers also found that the results remained consistent regardless of cirrhosis.

“The magnitude of risk reduction we observed within HCV patients with [type 2 diabetes] supports the importance of antiviral therapy among diabetic patients to reduce risk of these extrahepatic outcomes,” the researchers wrote.

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Li J, Gordon SC, Rupp LB, et al. Sustained virological response to hepatitis C treatment decreases the incidence of complications associated with type 2 diabetes.  [published online January 16, 2019]. Aliment Pharmacol Ther. doi: 10.1111/apt.15102