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Does telaprevir possess a direct antidiabetic effect?

Authors

  • Paulino Tallón de Lara,

    1. Division of Gastroenterology and Hepatology, University Hospitals, Geneva 4, Switzerland
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  • Thomas Himschoot,

    1. Division of Gastroenterology and Hepatology, University Hospitals, Geneva 4, Switzerland
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  • Jean-Louis Frossard,

    1. Division of Gastroenterology and Hepatology, University Hospitals, Geneva 4, Switzerland
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  • Francesco Negro

    Corresponding author
    1. Division of Gastroenterology and Hepatology, University Hospitals, Geneva 4, Switzerland
    2. Division of Clinical Pathology, University Hospitals, Geneva 4, Switzerland
    • Correspondence

      Professor Francesco Negro, Divisions of Clinical Pathology and Gastroenterology and Hepatology, University Hospital, 4 rue Gabrielle-Perret-Gentil, 1211 Geneva 4, Switzerland

      Tel: +41 22 3795800

      Fax: +41 22 3729366

      e-mail: francesco.negro@hcuge.ch

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Abstract

Hepatitis C virus (HCV) induces insulin resistance, which improves upon viral clearance. Telaprevir is a protease inhibitor effective against HCV genotype 1. We reported a case, whose history suggests that telaprevir may induce some antidiabetic effect independently of its suppression of HCV. A 56-year-old woman with obesity, type 2 diabetes treated with sitagliptin and metformin, and HCV-related cirrhosis was given triple therapy with pegylated interferon-alpha, ribavirin and telaprevir. After 2 weeks of treatment, HCV RNA was no longer detectable but the patient described a pronounced drop in the capillary glucose levels and episodes of hypoglycaemia that compelled her to stop all antidiabetic treatment. One month after stopping telaprevir, she had to resume her antidiabetic treatment, despite a persisting virological response. Despite reaching a sustained virological response, her diabetes progressed. Although the suppression of HCV replication may have played a role in reducing glucose intolerance, the fact that this patient resumed her prior antidiabetic treatment upon completing the telaprevir treatment, while still aviremic, suggests that telaprevir may have an additional antidiabetic effect. Further evidence about the possible role and mechanisms of telaprevir as antidiabetic agent is warranted.

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