engleski

Endocrine Manifestations of Chronic HCV infection.

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 since IR is associated with an increased rate of disease progression to fibrosis, cirrhosis and hepatocellular carcinoma. Also, interferon and ribavirin treatment of HCV hepatitis may be less successful in the presence of IR and the effect of IR on the new direct-acting antiviral treatment is unclear. 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.

Chronic hepatitis C ; metabolic alterations, type 2 diabetes mellitus ; insulin resistance

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