• Tyng-Yuan Jang, Chung-Feng Huang, Te-Sheng Chang, Chun-Chi Yang, Ching-Chu Lo, Chao-Hung Hung, Chien-Wei Huang, Lee-Won Chong, Pin-Nan Cheng, Ming-Lun Yeh, Cheng-Yuan Peng, Chien-Yu Cheng, Jee-Fu Huang, Ming-Jong Bair, Chih-Lang Lin, Chi-Chieh Yang, Szu-Jen Wang, Tsai-Yuan Hsieh, Tzong-Hsi Lee, Pei-Lun Lee, Wen-Chih Wu, Chih-Lin Lin, Wei-Wen Su, Sheng-Shun Yang, Chia-Chi Wang, Jui-Ting Hu, Lein-Ray Mo, Chun-Ting Chen, Yi-Hsiang Huang, Chun-Chao Chang, Chia-Sheng Huang, Guei-Ying Chen, Chien-Neng Kao, Chi-Ming Tai, Chun-Jen Liu, Mei-Hsuan Lee, Pei-Chien Tsai, Chia-Yen Dai, Jia-Horng Kao, Han-Chieh Lin, Wang-Long Chuang, Kuo-Chih Tseng, Chi-Yi Chen, Hsing-Tao Kuo, and Ming-Lung Yu.
• Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
• J Formos Med Assoc. 2024 Aug 20.

Background/AimsHepatitis C virus (HCV) eradication using antiviral agents augments the metabolic profile. Changes in glycated hemoglobin (HbA1c) levels in chronic hepatitis C patients who receive glecaprevir/pibrentasvir (GLE/PIB) remain elusive.MethodsData from 2417 patients treated with GLE/PIB from the Taiwan HCV Registry were analyzed, and pretreatment HbA1c levels were compared with 3-months after the-end-of treatment levels. A sustained virological response (SVR) was defined as undetectable HCV RNA at 12 weeks after the end of treatment. A significant change in HbA1c level was defined as the 75th percentile of the change in the HbA1c level before and after treatment (decrement >0.2%).ResultsSerum HbA1c levels decreased significantly (6.0 vs 5.9%, P < 0.001). Post-treatment HbA1c levels decreased in all subgroups, except in non-SVR patients (5.7 vs 5.7%, P = 0.79). Compared to patients without significant HbA1c improvement (decrement >0.2%), those with HbA1c improvement were older (60.2 vs 58.6 years, P < 0.001), had higher serum creatinine levels (1.9 vs 1.6 mg/dL, P < 0.001), triglycerides (129.8 vs 106.2 mg/dL, P < 0.001), fasting glucose (135.8 vs 104.0 mg/dL, P < 0.001), and pretreatment HbA1c (7.1 vs 5.7%, P < 0.001) and had a higher proportion of male sex (57.9% vs 50.9%, P = 0.003), diabetes (84.3 vs 16.8%, P < 0.001), more advanced stages of chronic kidney disease (CKD) (15.7 vs 11.1 %, P < 0.001), anti-diabetic medication use (47.3 vs 16.4%, P < 0.001) and fatty liver (49.6 vs 38.3 %, P < 0.001). Multivariate analysis revealed that the factors associated with significant HbA1c improvement were age (odds ratio [OR]/95% confidence intervals [CI]: 1.01/1.00-1.02, P = 0.01), HbA1c level (OR/CI: 2.83/2.48-3.24, P < 0.001) and advanced CKD stages (OR/CI: 1.16/1.05-1.28, P = 0.004). If the HbA1c variable was not considered, the factors associated with significant HbA1c improvement included alanine aminotransferase level (OR/CI, 1.002/1.000-1.004, P = 0.01), fasting glucose level (OR/CI: 1.010/1.006-1.013, P < 0.001), and diabetes (OR/CI: 3.35/2.52-4.45, P < 0.001).ConclusionsThe HbA1c levels improved shortly after HCV eradication using GLE/PIB. The improvement in glycemic control can be generalized to all subpopulations, particularly in patients with a higher baseline HbA1c level or diabetes.Copyright © 2024 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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