The impact of sofosbuvir/velpatasvir/voxilaprevir treatment on serum hyperglycemia in hepatitis C virus infections: a systematic review and meta-analysis. (31st December 2023)

• Record Type: Journal Article
• Authors: Hung, Hsuan-Yu; Lai, Hui-Hsiung; Lin, Hui-Chuan; Chen, Chung-Yu
• Is Part Of: Annals of medicine. Volume 55:Number 1(2023)
• Page Start: 463
• Page End: 479
• Publication Date: 2023-12-31
• Subjects: Hyperglycemia -- SOF/VEL/VOX -- Hepatitis C -- Diabetes; Medicine -- Periodicals; 610
• DOI: 10.1080/07853890.2023.2168745
• Languages: English
• ISSNs: 0785-3890

Abstract

Abstract: Background: The combination of Sofosbuvir (SOF), velpatasvir (VEL), and voxilaprevir (VOX) is an effective, safe rescue therapy for patients with previous treatment failure. Direct-acting antiviral (DAA) treatment for hepatitis C virus (HCV) infection in diabetics with a history of hypoglycemia could improve insulin resistance due to HCV clearance. However, some studies have shown that SOF/VEL/VOX causes grade 3 hyperglycemia and other adverse events, which contradicts the findings of other DAA studies. Aim: To analyze the incidence of grade 3 hyperglycemia of SOF/VEL/VOX for chronic HCV infection. Methods: We searched electronic databases from the inception of each database until October 2021. A random-effects model was employed to pool data. The study was conducted according to the PRISMA guidelines, and quality assessment was performed by using the Cochrane risk-of-bias tool for randomized controlled trials (RCTs). The study protocol was registered on the INPLASY database (Registration No. 2021120109). Results: Five RCTs were included in this review. Overall, 49 of 2315 patients had grade 3 hyperglycemia with a risk ratio of 0.015 (95% confidence interval, 0.010–0.020; p < .001), and the incidence risk ratio (IRR) for cirrhosis compared to without cirrhosis was 12.000 (95% confidence interval: 0.727–198.160), the HCV genotype 3–genotype 1 IRR was 4.13 (95% confidence interval: 1.52–11.22) in subgroup analysis. No significant differences were found within the other subgroups, in prior DAA treatment experience, and in treatment duration. Conclusion: Although the incidence of hyperglycemia was rare in diabetic patients with HCV, it is recommended that glucose levels be closely monitored during the first 3 months of therapy and that diabetes medication be modified if necessary.