Treatment of type 2 diabetes mellitus by viral eradication in chronic hepatitis C: Myth or reality?
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.
['Vanni|Ester|E|', 'Bugianesi|Elisabetta|E|', 'Saracco|Giorgio|G|']
D000998:Antiviral Agents D001786:Blood Glucose D016207:Cytokines D003924:Diabetes Mellitus, Type 2 D019698:Hepatitis C, Chronic D006801:Humans D007333:Insulin Resistance D008099:Liver D016896:Treatment Outcome
Diabetes mellitus Chronic hepatitis C Hepatitis C virus Insulin resistance Impaired fasting glucose Interferon Microangiopathy Ribavirin