Department of Oncology-Radiotherapy, Prof. Dr. Alexandru Trestioreanu Institute of Oncology, Bucharest, Romania.
Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
In Vivo. 2022 May-Jun;36(3):1438-1443. doi: 10.21873/invivo.12849.
BACKGROUND/AIM: Patients with hepatitis C virus (HCV)-associated cirrhosis are more prone to developing type 2 diabetes mellitus than patients with any other etiology of cirrhosis. The main objective of this study was to evaluate the impact of all oral antiviral treatment with ritonavir-boosted paritaprevir/ombitasvir and dasabuvir (OBV/PTV/r + DSV) in patients with chronic genotype 1b HCV infection.
We retrospectively evaluated 806 patients who underwent antiviral therapy between December 2015 and July 2019. The laboratory data analyzed were liver function tests, kidney function tests, HCV viremia, fasting glucose levels, and glycosylated hemoglobin.
Patients with impaired glucose metabolism were predominantly male and of older age compared to patients with normal glucose tolerance, and also had higher levels of transaminases. Proteinuria and higher creatinine levels were found in patients with impaired glucose metabolism. Overall, we found a 98.01% rate of sustained virologic response (SVR), with a non-significant difference between patients with normal and abnormal glucose metabolism. A statistically significant difference in SVR rates in patients with low degrees of fibrosis (F0-F2) versus those with advanced degrees of fibrosis (F3-F4) was found in both groups. Antiviral treatment resulted in significant decreases in fasting glucose levels and glycosylated hemoglobin levels in all patients with impaired glucose metabolism at SVR.
Patients with pre-diabetes, as well as diabetic patients, achieved a better glycemic control after SVR obtained by ritonavir-boosted paritaprevir/ombitasvir and dasabuvir.
背景/目的：与其他任何病因引起的肝硬化相比，丙型肝炎病毒（HCV）相关肝硬化患者更容易发生 2 型糖尿病。本研究的主要目的是评估利托那韦增强型 paritaprevir/ombitasvir 和 dasabuvir（OBV/PTV/r + DSV）全口服抗病毒治疗对慢性基因型 1b HCV 感染患者的影响。
我们回顾性评估了 2015 年 12 月至 2019 年 7 月期间接受抗病毒治疗的 806 例患者。分析的实验室数据包括肝功能检查、肾功能检查、HCV 病毒血症、空腹血糖水平和糖化血红蛋白。
与糖耐量正常的患者相比，葡萄糖代谢受损的患者主要为男性和年龄较大，且转氨酶水平较高。葡萄糖代谢受损的患者存在蛋白尿和较高的肌酐水平。总的来说，我们发现持续病毒学应答（SVR）率为 98.01%，葡萄糖代谢正常和异常的患者之间无显著差异。在两组患者中，纤维化程度较低（F0-F2）的患者与纤维化程度较高（F3-F4）的患者相比，SVR 率存在统计学显著差异。抗病毒治疗可使所有葡萄糖代谢受损患者的空腹血糖和糖化血红蛋白水平在 SVR 时显著降低。
在获得利托那韦增强型 paritaprevir/ombitasvir 和 dasabuvir 治疗的 SVR 后，患有糖尿病前期和糖尿病的患者血糖控制得到改善。
