Abstract: Objective The aim of this study was to observe the antiviral efficacy and blood glucose control of direct acting antivirals (DAAs) in treatment of patients with genotype 1b chronic hepatitis C (CHC) and type 2 diabetes mellitus(T2DM). Methods 62 patients (42 naïve and 20 re-treated) with CHC and T2DM with genotype 1b HCV infection were recruited in our hospital between May 2018 and January 2022, and were randomly divided into observation and control group, with 31 cases in each group. The patients with CHC in the observation group were treated with oral sofosbuvir/velpasvir administration, and those in the control were treated with peginterferon-α and ribavirin combination. The regimen in both groups lasted for 24 weeks, and all patients were followed-up for 24 weeks after discontinuation of the treatment. The antiviral efficacy was determined as for early virological response (EVR), virological response at the end of treatment (ETVR) and sustained virological response (SVR). The liver function tests, fasting blood glucose (FPG), glycosylated hemoglobin (HbA1c), fasting insulin and fasting C-peptide levels were measured, and the steady-state model insulin resistance index (HOMA-IR) was calculated. Results The EVR, ETVR and SVR in the observation group were 87.1%, 100.0% and 96.8%, all significantly higher than 58.1%, 71.0% and 64.5% (P<0.05) in the control; at the end of 24 week treatment, serum ALT, AST and GGT levels in the observation group were 35(23, 47)U/L, 31(19, 47)U/L and 62(38, 81)U/L, all significantly lower than [39(36, 57)U/L, 42(34, 64)U/L and 80(47, 104)U/L, P<0.05] in the control; the FPG, serum HbA1c, HOMA-IR and fasting serum C peptide levels in the observation group were 6.1(5.0, 7.9)mmol/L, 7.1(6.0, 9.2)%, 2.2(1.8, 3.1) and 1.6(1.2, 2.2)ng/ml, all significantly lower than [7.1(5.5, 9.4)mmol/L, 7.8(6.4, 9.4)%, 2.8(2.1, 3.4) and 2.2(1.6, 2.4)ng/ml, P<0.05] in the control group. Conclusion The oral administration of sofosbuvir and velpasvir combination treatment is efficacious in patients with CHC with genotype 1b HCV infection and T2DM , which seems not impacting the blood sugar control.

Key words: Hepatitis C, Genotype 1b HCV infection, Type 2 diabetes mellitus, Direct acting antivirals, Sofosbuvir and velpasvir, Sustained virological response, Therapy