HepCInfo Updates

HepCInfo Update 9.3 

Welcome to CATIE's HepCInfo Update 9.3 for January 20 to February 2, 2018. Read on to learn more about new and updated scientific findings in hepatitis C prevention, care, treatment and support.

New and noteworthy

Being cured of hepatitis C improves insulin resistance in people with genotype 1 virus

People with genotype 1 virus who were cured of hepatitis C had significant improvements in insulin resistance or a reversal of insulin resistance, reported researchers in the Journal of Gastroenterology and Hepatology.

Insulin is a hormone that helps the body use a sugar called glucose, which the body uses as energy. When a person has insulin resistance (IR), the body does not respond to insulin as it should and glucose builds up in the blood leading to complications. Over time, persistently elevated blood glucose levels can lead to pre-diabetes and type 2 diabetes. These conditions cause a range of health complications.

In this study, 68 people with genotype 1 virus and advanced liver injury received one of the following three direct-acting antiviral (DAA) combinations with ribavirin: Holkira Pak, Harvoni or the combination of simeprevir and sofosbuvir.

There were also 65 people with hepatitis C who were not treated and served as a comparison group. No participants in either group made significant changes to their lifestyle, diet or physical activity levels while they were in the study.

All participants in the treatment group were cured of hepatitis C.

Over three-quarters (76%, 52 people) of participants who were cured showed a decrease in IR. Of these, 40% (21 people) had normal levels of insulin. Having a high level of liver injury was linked to having some degree of IR in people who were cured.

The comparison group did not show any changes in IR.

According to the researchers, “The data underline a role of hepatitis C in [the] development of IR and that viral eradication reverses IR and improves glycemic control and this could prevent IR-related clinical manifestations and complications.” (Healio.com, December 2017)

People with hepatitis C are at higher risk of kidney disease but hepatitis C treatment decreases risk

People with hepatitis C are at a 27% increased risk of developing chronic kidney disease compared to people without hepatitis C, however being treated and cured of hepatitis C decreases this risk, reported researchers in Hepatology.

The researchers examined a database of U.S. residents in medical care from 2008 to 2015.  They assembled a cohort of 56,448 people with hepatitis C and a comparison group of 169,344 people who did not have hepatitis C.

A total of 1,455 people in the hepatitis C group were diagnosed with chronic kidney disease (CKD) during the study period, compared with 2,518 people in the non–hepatitis C group.

In the hepatitis C group, 11, 828 people received treatment with peg-interferon and ribavirin with or without a direct-acting antiviral (DAA) medication or a DAA-only combination.

People with hepatitis C who received hepatitis C treatment had a 30% lower risk of being diagnosed with CKD, although these results were not statistically significant for group who took the DAA-only combination.

According to the researchers, “These findings highlight that treating hepatitis C early helps to change the extrahepatic burden of CKD associated with hepatitis C.” (infohep.org, December 2017)

Straight to the source for new science

Hepatitis C and human immunodeficiency virus coinfection in the era of direct-acting antiviral agents: no longer a difficult-to-treat population, Hepatology, January 2018

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