Influence of antiviral treatment in hepatitis C patients on metabolism and fibrosis process

Background: Chronic Hepatitis C Virus (HCV) infection is associated with systemic metabolic disturbances, including glucose intolerance, lipid dysregulation, and inflammation, accelerating liver fibrosis and increasing hepatocellular carcinoma risk. Biomarkers such as Glucagon-Like Peptide-1 (GLP-1), Fatty Acid-Binding Protein 1 (FABP-1), Monocyte Chemoattractant Protein-1 (MCP-1), Angiopoietin-Like Protein 6 (ANGPTL6), ibroblast Growth Factor 19 (FGF-19), and ghrelin offer insights into these mechanisms and may reflect the impact of antiviral treatments. Objectives: This study evaluated the effects of two direct-acting antiviral (DAA) regimens-Glecaprevir/Pibrentasvir (G/P) and Sofosbuvir/Velpatasvir (S/V)-on metabolic and inflammatory biomarkers in 70 HCV-infected patients with comorbidities including obesity, type 2 diabetes, and hypertension. Methods: Serum biomarker levels were assessed pre- and post-treatment using the Luminex FlexMAP 3D system. Patients were stratified by treatment type, fibrosis stage (F0-F4), and baseline cholesterol. Liver stiffness was evaluated via FibroScan. Results: Both regimens induced significant biomarker changes. ANGPTL6, FGF-19, ghrelin, total cholesterol, HDL, and non-HDL increased, while FABP-1 and MCP-1 decreased, indicating reduced inflammation and lipid stress. Stronger effects were seen in patients with lower baseline cholesterol and with S/V in advanced fibrosis. G/P showed marked anti-inflammatory effects in early fibrosis. Conclusion: DAA therapy significantly alters metabolic and inflammatory biomarkers in HCV patients, with regimen- and fibrosis stage-specific effects. S/V may provide broader metabolic benefits in advanced disease, while G/P offers stronger anti-inflammatory responses earlier, supporting personalized treatment approaches.