THE RELATIONSHIP BETWEEN CHRONIC HEPATITIS C VIRUS AND DIABETES MELLITUS

Relevance. Chronic hepatitis C (CHC) and type 2 diabetes mellitus (T2DM) are among the most common and serious problems in modern medicine. Hepatitis C virus (HCV) affects millions of people worldwide and leads to significant socioeconomic consequences and remains one of the main causes of chronic liver diseases such as fibrosis, cirrhosis and hepatocellular carcinoma (HCC). Objective. To analyze the relationship between HCV infection and the development of type 2 diabetes mellitus, with an emphasis on pathophysiological mechanisms, clinical outcomes and the effect of antiviral therapy on glucose metabolism and insulin resistance (IR). Materials and methods. Scientific articles, studies, and statistical data from PubMed, Karger, RKI, Onlinelibrary, CDC, Ecdc, and the Ukrainian Center for Public Health databases were analyzed. Methods of systematic literature review and comparative analysis of clinical outcomes were used. Results. The relationship between HCV and the development of T2DM was analyzed with an emphasis on pathophysiological mechanisms, clinical outcomes, and the effect of antiviral therapy on glucose metabolism and IR. The pathophysiological mechanisms that determine the relationship between these diseases are discussed. Particular attention is paid to IR as a key factor in the development of diabetes mellitus in patients with HCV. Studies confirm that HCV directly affects insulin signaling pathways in liver cells and muscles, causing a systemic inflammatory process that disrupts glucose metabolism. The article presents statistics on the prevalence of T2DM among patients with CHC. It is noted that the prevalence of diabetes among patients with hepatitis is significantly higher than in the general population. The impact of direct-acting antiviral drugs (DAAs), which help to improve metabolic control, reduce blood glucose levels and reduce the need for insulin therapy, is highlighted. The need for further studies to assess the long-term effects of HCV treatment on glucose metabolism is emphasized, as well as the importance of developing new therapeutic approaches for the treatment of patients with coexisting HCV and T2DM. Conclusions. Chronic HCV infection and T2DM are closely related pathophysiologic conditions with significant clinical consequences. HCV contributes to the development of IR, which is a key mechanism of diabetes development in these patients and is provoked by the virus, disrupts glucose metabolism even in patients without classical risk factors such as obesity or metabolic syndrome. DAAs have proven to be highly effective in achieving a sustained virologic response, which contributes to a significant improvement in glycemic control. These drugs not only eliminate the virus, but also reduce the level of IR, which improves metabolic parameters in patients with T2DM. Virus eradication can reduce or eliminate the need for insulin therapy, improving the quality of life of patients.