Impact of hepatitis C virus therapy on metabolism and public health

Abstract

Chronic hepatitis C virus ( HCV ) is associated with insulin resistance ( IR ) and leads to type 2 diabetes mellitus (T2 DM ) and hepatic steatosis in many patients. These metabolic complications of HCV have been shown to accelerate the progression of fibrosis to cirrhosis and increase the risk of hepatocellular carcinoma. The metabolic syndrome is a common disorder that also includes IR , T2 DM and hepatic steatosis. Approximately 20%- 30% of patients with chronic HCV also have co- existent metabolic syndrome. The cause of steatosis in patients with the features of both the metabolic syndrome and chronic HCV is sometime difficult to determine. Patients with metabolic syndrome and chronic HCV are also at risk of developing renal, cardiovascular and cerebrovascular disease. Recent data suggest that HCV is an independent risk factor for renal, coronary and cerebral vascular disease, and may increase mortality associated with these disorders. The treatment of HCV can now result in a sustained virological response and cure nearly all patients with chronic HCV. The eradication of HCV reduces the risk of developing IR and T2 DM , improves IR and 2 TDM , reduces the risk of developing chronic kidney disease, end- stage renal disease, acute cardiac syndrome and stroke in patients with 2 TDM . Thus, treatment of chronic HCV can provide a significant public health benefit, but only if all patients with chronic HCV are identified and universally treated.

 

K E Y W O R D S

hepatitis C virus , insulin resistance , metabolic syndrome , type 2 diabetes mellitus

About Speaker

Mitchell SHIFFMAN

Director Liver Institute of Virginia

USA

City: Richmond

Institution: Liver Institute of Virginia

Contact: Mitchell_Shiffman@bshsi.org


Biography of Mitchell SHIFFMAN

Dr Mitchell L Shiffman is the Director of the Liver Institute of Virginia at the Bon Secours Virginia Health System with offices in Richmond and Newport News, Virginia. He is also a Clinical Professor Medicine at the Eastern Virginia Medical School in Norfolk, Virginia. Dr Shiffman received his MD degree from the State University of New York Upstate Medical Center in Syracuse, completed residency and fellowship training in Internal Medicine, Gastroenterology and Hepatology at the Virginia Commonwealth University-Medical College of Virginia. He was the Chief of the Hepatology Section and Medical Director of the Liver Transplant Program at the VCU Medical Center in Richmond, Virginia between 1990-2009. Dr Shiffman has published over 275 articles in peer reviewed medical journals invited reviews and/or book chapters and has edited 3 textbooks on liver disease. He has organized and co-chaired 2 NIH development conferences. He has participated in clinical research studies for many different liver disorders although the majority of his writings and clinical research have focused on viral hepatitis C.

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