title: Treatment of type 2 diabetes mellitus by viral eradication in chronic hepatitis C: Myth or reality?
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.
authors.affiliation: Gastro-hepatology Unit, Department of Medical Sciences, University of Turin, Turin, Italy.
authors.forename: Ester
authors.initials: E
authors.lastname: Vanni
authors.affiliation: Gastro-hepatology Unit, Department of Medical Sciences, University of Turin, Turin, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Bugianesi
authors.affiliation: Gastroenterology Unit, Oncology Department, University of Turin, Italy. Electronic address: g.saracco@tin.it.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Saracco
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D001786:Blood Glucose / Q000378:metabolism*; D016207:Cytokines / Q000276:immunology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000276:immunology / Q000378:metabolism*; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology / Q000378:metabolism; D006801:Humans; D007333:Insulin Resistance / Q000276:immunology; D008099:Liver / Q000276:immunology* / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D001786:Blood Glucose; D016207:Cytokines
keywords: Chronic hepatitis C; Diabetes mellitus; Hepatitis C virus; Impaired fasting glucose; Insulin resistance; Interferon; Microangiopathy; Ribavirin