Elsayed, M., Ibrahim, I., Amer, K. (2019). Insulin resistance and portal heamodynamics changes before and after treatment by new direct antivirals drugs in chronic HCV. Afro-Egyptian Journal of Infectious and Endemic Diseases, 9(2), 150-157. doi: 10.21608/aeji.2019.12816.1025
Mahmoud A Elsayed; Ibrahim M Ibrahim; Kamal A Amer. "Insulin resistance and portal heamodynamics changes before and after treatment by new direct antivirals drugs in chronic HCV". Afro-Egyptian Journal of Infectious and Endemic Diseases, 9, 2, 2019, 150-157. doi: 10.21608/aeji.2019.12816.1025
Elsayed, M., Ibrahim, I., Amer, K. (2019). 'Insulin resistance and portal heamodynamics changes before and after treatment by new direct antivirals drugs in chronic HCV', Afro-Egyptian Journal of Infectious and Endemic Diseases, 9(2), pp. 150-157. doi: 10.21608/aeji.2019.12816.1025
Elsayed, M., Ibrahim, I., Amer, K. Insulin resistance and portal heamodynamics changes before and after treatment by new direct antivirals drugs in chronic HCV. Afro-Egyptian Journal of Infectious and Endemic Diseases, 2019; 9(2): 150-157. doi: 10.21608/aeji.2019.12816.1025
Insulin resistance and portal heamodynamics changes before and after treatment by new direct antivirals drugs in chronic HCV
Tropical Medicine Department, Faculty of Medicine, Zagazig University,Egypt.
Abstract
Background and study aim: Insulin resistance is typically associated with chronic hepatitis C virus and its improvement after treatment of HCV with new direct antiviral drugs may change portal hemodynamics. This study aimed at assessing changes in HOMA-IR, APRI score and platelet count/spleen diameter ratio as fibrotic markers and changes of portal hemodynamics after treatment with direct- acting antiviral drugs. Patients and Methods: TheStudy included 100 chronic HCV patients who were eligible for treatment with direct-acting antiviral drugs. HOMA-IR, APRI score and platelet count/ spleen diameter ratio and changes of portal hemodynamics were calculated. Results: The noninvasive indices of liver fibrosis were assessed before and after HCV treatment. Insulin resistance improved significantly after treatment from (3.2±0.9) to (2.9±0.7). Doppler parameters of the studied group also showed marked improvement after treatment where the portal vein flow velocity and flow volume increased (15.8 ±1.7 vs 16.1±1.3) and (728.3±128.2 vs 1059.9±29.6) respectively. Hepatic artery resistive index and calculated congestive index of portal vein also, showed improvement (0.6±0.1 vs 0.49±0.1) (0.077 ±0.014 vs 0.051 ± 0.017) respectively. Conclusion: Direct-acting antiviral drugs may reduce inflammatory and fibrotic sequelae of HCV infection. Also, portal hypertensive indices improved and HOMA-IR, APRI score and platelet count/splenic diameter ratio show improvement.
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