Systematic Reviews
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 7, 2017; 23(9): 1697-1711
Published online Mar 7, 2017. doi: 10.3748/wjg.v23.i9.1697
Diabetes mellitus, insulin resistance and hepatitis C virus infection: A contemporary review
Anne-Claire Desbois, Patrice Cacoub
Anne-Claire Desbois, Patrice Cacoub, Inflammation-Immunopathology-Biotherapy Department, Sorbonne Universités, 75005 Paris, France
Anne-Claire Desbois, Patrice Cacoub, UMR_S 959, French National Institute of Health and Medical Research, 75013 Paris, France
Anne-Claire Desbois, Patrice Cacoub, FRE3632, The French National Center for Scientific Research, 75005 Paris, France
Anne-Claire Desbois, Patrice Cacoub, Department of Internal Medicine and Clinical Immunology, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, 75013 Paris, France
Author contributions: Desbois AC and Cacoub P designed research, contributed to new reagents or analytic tools, analyzed data, and wrote the paper; Desbois AC performed research.
Conflict-of-interest statement: Pr P. Cacoub has received consulting and lecturing fees from: Abbvie, Astra Zeneca, Bristol-Myers Squibb, Gilead, Glaxo Smith Kline, Janssen, and Merck Sharp Dohme. Dr AC Desbois has received lecturing fees from Gilead.
Data sharing statement: No additional unpublished data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Patrice Cacoub, MD, PhD, professor, Department of Internal Medicine and Clinical Immunology, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, 83 boulevard de l'hôpital, 75013 Paris, France. patrice.cacoub@aphp.fr
Telephone: +33-1-42178009 Fax: +33-1-42178033
Received: October 3, 2016
Peer-review started: October 7, 2016
First decision: October 28, 2016
Revised: November 10, 2016
Accepted: February 7, 2017
Article in press: February 8, 2017
Published online: March 7, 2017
Processing time: 153 Days and 13.8 Hours
Abstract
AIM

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.

CONCLUSION

Glucose abnormalities are strongly associated with HCV infection and show a negative impact on the main liver related outcomes.

Keywords: Hepatitis C virus; Diabetes mellitus; Insulin resistance; Liver fibrosis; Treatment

Core tip: hepatitis C virus (HCV) infection is associated with increased rates of glucose abnormalities, including diabetes mellitus and insulin resistance. The presence of glucose abnormalities in HCV infected patients, including diabetes mellitus and insulin resistance, is associated with negative liver-related outcomes (i.e., severe liver fibrosis, decreased response to antivirals, and increased occurrence of hepatocellular carcinoma).