In a large cohort of patients with HCV, the use of DAA was associated with significantly lower incidence and risk for subsequent diabetes.
In a large cohort of patients with hepatitis C virus (HCV), the use of direct-acting antiviral agents (DAA) was associated with significantly lower incidence and risk for subsequent diabetes, according to data published in Clinical Infectious Diseases.
This study used the ERCHIVES database of patients with chronic HCV infection to identify 4764 patients treated with a pegylated interferon and ribavirin regimen (PEG/RBV) and 21,279 treated with a DAA-containing regimen. Patients treated with both regimens or those with diabetes at baseline were excluded. To determine the effect of treatment regimen on risk for diabetes, propensity score-matched controls were also identified.
The incidence rates of diabetes among participants who did not receive treatment, those who were treated with PEG/RBV, and those who received DAA treatment were 20.6/1000 person years (95% CI, 19.6-21.6), 19.8/1000 person years (95% CI, 8.13,-21.4), and 9.89/1000 person years (95% CI, 8.7-11.1), respectively. Among those who were treated, rates were 13.3 (95% CI, 12.2-14.5) for those with sustained virologic response and 19.2 (95% CI, 17.4-21.1) for those without (P <.0001).
The study investigators also observed a larger reduction in persons with more advanced fibrosis/cirrhosis (absolute difference 2.9 for FIB-4 score <1.25; 5.7 for FIB-4 score 1.26-3.25; 9.8 for FIB-4 score >3.25). Both DAA (hazard ratio [HR], 0.53; 95%CI, 0.46-0.63) and sustained virologic response (HR 0.81; 95%CI, 0.70-0.93) were associated with significantly reduced risk for diabetes. Those who received DAAs had longer diabetes-free survival compared with untreated patients and those treated with PEG/RBV. However, there was no difference in diabetes-free survival between the untreated and PEG/RBV-treated persons.
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