The Effect Of Direct Acting Antiviral Drugs on miRNA-122 And Insulin Resistance In Chronic HCV Patients

The hepatitis C virus (HCV) is an enveloped, single-stranded positive-sense Ribo-Nucleic Acid virus which is a major cause of chronic liver diseases, including cirrhosis and hepatocellular carcinoma (HCC), and infects approximately 3 % of the world population(150-170 million).

One of the countries most affected by HCV is Egypt. The Egyptian Demographic and Health Surveys measured antibody prevalence among the adult population aged 15-59 years at 14.7% in 2009 and at 10.0% in 2015 To attend to this challenge, Egypt developed a national strategy for Hepatitis C Virus control and established HCV prevention and treatment programs using Direct Acting-Antivirals (DAAs).

Egypt launched an ambitious national HCV treatment program aiming to treat over 250,000 chronically infected individuals per year, with the goal of achieving a national chronic infection prevalence of <2% by 2025.

Although the consequences of chronic HCV infection are generally associated with liver manifestations such as hepatic fibrosis, cirrhosis, steatosis (known as non-alcoholic fatty liver disease, NAFLD) and HCC, the liver-related mortality of 350,000 individuals annually is still underestimated due to the lack of consideration of extrahepatic effect including a growing evidence showing that HCV infection is strongly associated with the dysregulation of glucose homoeostasis such as insulin resistance (IR) and type 2 diabetes (T2D).

HCV-related type 2 diabetes mellitus may arise from a complex interaction between IR, steatosis and inflammatory processes People infected with HCV are 4 times more likely to develop Type 2 Diabetes; and HCV-infected patients with uncontrolled glucose are at higher risk to develop advanced liver fibrosis, HCC, and exhibit decreased sustained virologic response (SVR) to traditional interferon treatment.