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- W1933492768 abstract "Potential conflict of interest: Dr. Chung received grants from Gilead, AbbVie, Merck, Bristol‐Myers Squibb, Janssen, and Mass Biologics. We appreciate the letter from Dr. Soriano and colleagues, who describe a case of successful treatment of chronic hepatitis C virus (HCV) infection with sofosbuvir and ledipasvir in a diabetic patient marked by a simultaneous reduction in insulin requirements. As noted by the authors, the link between insulin resistance and HCV is well established. HCV is an independent risk factor for diabetes, particularly in patients who exhibit other components of metabolic syndrome.1 HCV‐mediated insulin resistance is also strongly correlated with hepatic fibrosis progression and incident hepatocellular carcinoma (HCC).2 The eradication of HCV correlates strongly with a reduced risk of cirrhosis, need for liver transplantation, and development of HCC.3 However, the clinical benefits of viral clearance extend beyond the prevention of liver‐related outcomes. In population‐based cohorts, sustained virological response has been linked to improvements in all‐cause mortality, cardiovascular death, and other (non‐HCC) malignancy, compared to nonresponders.4 Viral clearance is also associated with decreased circulating levels of several proinflammatory and atherogenic markers, including intercellular adhesion molecule 1, vascular cell adhesion molecule 1, and tumor necrosis factor alpha.5 There is also mounting evidence that viral clearance is linked to reduction in insulin resistance as well as reduced rates of incident diabetes.6 The case described by Soriano et al. illustrates the relationship between viral eradication and changes in glucose tolerance. In so doing, the authors highlight an important secondary benefit of anti‐HCV therapy. Collectively, both available and emerging data serve to reinforce the recommendation that all patients with chronic hepatitis C should be treated.7" @default.
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- W1933492768 date "2015-11-26" @default.
- W1933492768 modified "2023-10-16" @default.
- W1933492768 title "Reply" @default.
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- W1933492768 doi "https://doi.org/10.1002/hep.28136" @default.
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