# Effect of Direct-Acting Antiviral Therapy on Glycemic Control in Patients with Chronic Hepatitis C and Type 2 Diabetes: A Systematic Review and Meta-Analysis

## TL;DR

Treating hepatitis C with DAAs improves blood sugar control in patients with type 2 diabetes, but results vary widely.

## Contribution

This study quantifies the impact of DAA therapy on glycemic control in T2DM patients with HCV.

## Key findings

- DAA therapy led to a significant average 0.45% reduction in HbA1c after SVR.
- The effect was highly variable across studies, with heterogeneity at 97.8%.
- HCV appears to be a modifiable factor contributing to chronic hyperglycemia.

## Abstract

The eradication of hepatitis C virus (HCV) with interferon-free direct-acting antivirals (DAAs) has transformed the management of chronic HCV infection. Chronic HCV infection is associated with an increased risk of type 2 diabetes mellitus (T2DM) and poor glycemic control. However, the magnitude and consistency of improvement in glycated hemoglobin (HbA1c) after DAA-induced sustained virologic response (SVR) in patients with established T2DM remain unclear. We conducted a systematic review and meta-analysis of six cohort studies comprising 2805 patients. Overall, DAA therapy was associated with a significant reduction in HbA1c after SVR, with a pooled random-effect mean difference of −0.45% (95% CI −0.74% to −0.16%; I2 = 97.8%). This effect is highly heterogeneous but suggests that HCV may be a modifiable contributor to chronic hyperglycemia. These findings highlight the need for close glucose monitoring and individualized adjustment of antidiabetic therapy after SVR to optimize metabolic outcomes.