Diabetes mellitus, insulin resistance and hepatitis C virus infection: A contemporary review.
OBJECTIVE
To summarise the literature data on hepatitis C virus (HCV)-infected patients concerning the prevalence of glucose abnormalities and associated risk.


METHODS
We conducted a PubMed search and selected all studies found with the key words "HCV" or "hepatitis C virus" and "diabetes" or "insulin resistance". We included only comparative studies written in English or in French, published from January 2000 to April 2015. We collected the literature data on HCV-infected patients concerning the prevalence of glucose abnormalities [diabetes mellitus (DM) and insulin resistance (IR)] and associated risk [i.e., severe liver fibrosis, response to antivirals, and the occurrence of hepatocellular carcinoma (HCC)].


RESULTS
HCV infection is significantly associated with DM/IR compared with healthy volunteers and patients with hepatitis B virus infection. Glucose abnormalities were associated with advanced liver fibrosis, lack of sustained virologic response to interferon alfa-based treatment and with a higher risk of HCC development. As new antiviral therapies may offer a cure for HCV infection, such data should be taken into account, from a therapeutic and preventive point of view, for liver and non-liver consequences of HCV disease. The efficacy of antidiabetic treatment in improving the response to antiviral treatment and in decreasing the risk of HCC has been reported by some studies but not by others. Thus, the effects of glucose abnormalities correction in reducing liver events need further studies.


CONCLUSIONS
Glucose abnormalities are strongly associated with HCV infection and show a negative impact on the main liver related outcomes.
Anne-Claire Desbois, Patrice Cacoub, Inflammation-Immunopathology-Biotherapy Department, Sorbonne Universités, 75005 Paris, France.
Anne-Claire
AC
Desbois
Anne-Claire Desbois, Patrice Cacoub, Inflammation-Immunopathology-Biotherapy Department, Sorbonne Universités, 75005 Paris, France.
Patrice
P
Cacoub
D000998:Antiviral Agents / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis; D006528:Carcinoma, Hepatocellular / Q000150:complications; D048909:Diabetes Complications / Q000628:therapy*; D064368:Healthy Volunteers; D006526:Hepatitis C / Q000150:complications* / Q000628:therapy*; D006706:Homeostasis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007333:Insulin Resistance; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications; D015995:Prevalence; D012720:Severity of Illness Index
D000998:Antiviral Agents; D001786:Blood Glucose; D007004:Hypoglycemic Agents
Diabetes mellitus; Hepatitis C virus; Insulin resistance; Liver fibrosis; Treatment