According to the results of a real-world cohort study, a reduced risk of incident diabetes was observed in patients with hepatitis C virus (HCV) infection who were treated with direct-acting antiviral (DAA) therapy compared with those who were left untreated.

The study compared US administrative claims data of HCV patients with ≥12 weeks of dispensed DAA therapy (N=17,848) to untreated HCV patients with follow-up data (N=108,350). “Treated patients were followed from start of DAA treatment; follow-up start times in untreated patients were established to match the distribution of treatment start times in the treated patients,” the study authors explained. 

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Patients included in the study were required to have ≥1 year of prior enrollment as well as no evidence of type 2 diabetes before the start of the follow-up period. Events were assessed by diagnostic claims for type 2 diabetes or antidiabetic medication use.

Baseline risk factors varied greatly between the 2 groups. DAA-treated patients were found to be older, had a higher risk of hypertension and beta blocker- and calcium channel blocker-use, and were less likely to have hyperlipidemia. The study authors reported that the unadjusted incidence rate of type 2 diabetes was found to be 2.65 events per 100 person-years in DAA-treated patients versus 3.14 events per 100 person-years in untreated patients. Additionally, a reduced risk of incident type 2 diabetes was observed in DAA-treated patients versus untreated patients after adjusting for age, gender, baseline comorbidities, and medication use (HR 0.79; 95% CI: 0.72, 0.86).

The risk of incident type 2 diabetes was found to be lower in HCV patients treated with DAA therapy compared to those who did not receive therapy. “This finding provides additional evidence for the benefits of curative DAA therapy in reducing extrahepatic complications of HCV and is of particular importance given the association of diabetes with increased risk of cirrhosis and hepatocellular carcinoma in HCV patients,” the study authors concluded.


Singer A, Osinusi, AO, Brainard D, Telep L, Chokkalingam A. Risk of Incident Diabetes in Hepatitis C Patients Following Completion of Direct-Acting Antiviral Therapy. Presented at AASLD The Liver Meeting 2018. Study number 0589.