Effect of Direct Acting Anti-Viral Drugs on Insulin Resistance and sensitivity Among Egyptian Chronic HCV Infected Patients

Abstract

HCV is a major health problem worldwide. If untreated, it induces liver fibrosis, steatosis, cirrhosis, and finally hepatocellular carcinoma. There has been a rapid advancement in anti-HCV therapy from the era of PegIFN/ RBV therapy to the advent of interferon-free oral DAAs, with a progressive improvement in the SVR rates. The goal of HCV treatment is to eradicate the virus and prevent the development of cirrhosis and its complications. Despite this advancement, there are still patients who are non-responders and require meticulous care. Insulin resistance (IR) is commonly associated with chronic HCV infection. It is a risk factor treatment failure with PegIFN/RBV. Insulin resistance (IR) is a complex pathophysiological condition where higher-than-normal concentrations of insulin are needed to maintain a normal glycemia and adequate glucose utilization in insulin target tissues. This study was designed to assess the impact of direct acting anti-viral drugs on the status of insulin resistance and sensitivity in non-diabetic chronic HCV infection patients who received the drugs and achieved SVR after 12 weeks by using the main parameters used to calculate insulin resistance and sensitivity: HOMA-IR, QUICKI and Matsuda index.