This study is a cohort study that was performed on two groups of patients recruited from the hepatology and virology outpatient clinic at Ain Shams University Hospital (MASRI: faculty of Medicine, Ain Shams Research Institute) and Ain Shams University treatment and research unit.

Group I included 50 patients with chronic hepatitis C virus infection who were treated with DAAs (sofosbuvir/daclatasvir/ribavirin) for 12 weeks (this group belongs to the difficult to treat group according to the National Committee for Control of Viral Hepatitis in Egypt, 2016).

Group II included 50 patients with chronic hepatitis C virus infection who were treated with DAAs (ombitasvir, paritaprevir, ritonavir/ribavirin) for 12 weeks (this group belongs to the treatment of patients with an eGFR of 30 ml/min or less according to the National Committee for Control of Viral Hepatitis in Egypt, 2016).

Figure 1 shows and compares each group before and after treatment with DAAs and the two groups as regards the BMI of the study population. Patients in group I had a BMI before treatment ranging between 24.5 and 29 with a mean of 27.114 ± 1.161, BMI after treatment ranging between 25.2 and 29 with a mean of 27.252 ± 1.009. There was a statistically significant difference before and after treatment where the p value was 0.021. While patients in group II had BMI before treatment ranging between 24.2 and 28.4 with a mean of 26.486 ± 1.165 and BMI after treatment ranging between 24 and 28.1 with a mean of 26.500 ± 1.008, there was no statistically significant difference between before and after treatment where the p value was 0.855. There was a statistically significant difference as regards BMI between the two groups where the p value was 0.008 before treatment and 0.001 after treatment.

Fig. 1
figure 1

Comparison between each group before and after treatment and the two studied groups according to BMI

Table 1 shows that patients in group I had a statistically significant difference as regards PLT before and after treatment where the p value was < 0.001. Also, patients in group II had a statistically significant difference as regards PLT before and after treatment, where the p value was <0.001. There was a statistically significant difference as regards PLT between the two groups where the p value was <0.001 before and after treatment.

Table 1 Comparison between each group before and after treatment and the two studied groups according to platelet count

Table 2 showed that patients in group I had a statistically significant difference as regards AST, ALT, total bilirubin, serum albumin, and INR before and after treatment, where the p value was 0.005. Also, patients in group II had a statistically significant difference as regards AST and INR before and after treatment, where the p value was 0.014. But, patients in group II had no statistically significant difference as regards ALT, total bilirubin, and serum albumin before and after treatment, where the p value was 0.475. There was a statistically significant difference as regards AST, ALT, total bilirubin, serum albumin, and INR between the two groups where the p value was <0.001 before and after treatment.

Table 2 Comparison between each group before and after treatment and the two studied groups according to liver profile

Table 3 describes and compares each group before and after treatment with DAAs and the two groups as regards the total cholesterol level of the study population. Patients in group I had total cholesterol levels before treatment ranging between 117 mg/dl and 190 mg/dl with a mean of 153.260 ± 20.101 mg/dl and total cholesterol after treatment ranging between 129 and 207 mg/dl with a mean of 174.120 ± 19.050 mg/dl. There was a significant statistical difference before and after treatment where the p value was <0.001. While patients in group II had total cholesterol before treatment ranging between 130 and 256 mg/dl with a mean of 174.000 ± 35.001 mg/dl, and total cholesterol after treatment ranging between 135 and 223 mg/dl with a mean of 178.200 ± 24.396 mg/dl, there was no significant statistical difference between before and after treatment where the p value was 0.182. There was a significant statistical difference as regards total cholesterol between the two groups before treatment, where the p value was <0.001, but there was no significant statistical difference after treatment, where the p value was 0.354.

Table 3 Comparison between each group before and after treatment and the two studied groups according to total cholesterol level

Table 4 describes and compares each group before and after treatment with DAAs and the two groups as regards the triglyceride level of the study population. Patients in group I had triglycerides before treatment ranging between 60 and 142 mg/dl with a mean of 113.220 ± 22.933 mg/dl, and triglycerides after treatment ranging between 53 and 152 mg/dl with a mean of 105.660 ± 23.272 mg/dl. There was a significant statistical difference before and after treatment where the p value was <0.001. While patients in group II had triglycerides before treatment ranging between 67 and 194 mg/dl with a mean of 120.320 ± 36.072 mg/dl and triglycerides after treatment ranging between 65 and 168 mg/dl with a mean of 124.100 ± 27.763 mg/dl, there was no significant statistical difference between before and after treatment where the p value was 0.258. There was no significant statistical difference as regards triglyceride between the two groups before treatment, where the p value was 0.243, but there was a significant statistical difference after treatment, where the p value was 0.001.

Table 4 Comparison between each group before and after treatment and the two studied groups according to triglyceride level

Table 5 describes and compares each group before and after treatment with DAAs and the two groups as regards the HDL level of the study population. Patients in group I had HDL before treatment ranging between 32 and 73 mg/dl with a mean of 54.660 ± 10.149 mg/dl, HDL after treatment ranging between 34 and 75 mg/dl with a mean of 57.280 ± 10.321 mg/dl. There was a significant statistical difference before and after treatment where the p value was 0.010. While patients in group II had HDL before treatment ranging between 40 and 74 mg/dl with a mean of 56.500 ± 10.009 mg/dl, HDL after treatment ranging between 40 and 72 mg/dl with a mean of 54.580 ± 8.026 mg/dl, there was a significant statistical difference between before and after treatment where the p value was 0.042. There was no significant statistical difference as regards HDL between the two groups, where the p value was 0.364, 0.147 before and after treatment, respectively.

Table 5 Comparison between each group before and after treatment and the two studied groups according to HDL Level

Table 6 describes and compares each group before and after treatment with DAAs and the two groups as regards the LDL level of the study population. Patients in group I had LDL before treatment ranging between 56 and 94 mg/dl with a mean of 74.700 ± 9.921 mg/dl, LDL after treatment ranging between 59 and 114 mg/dl with a mean of 93.300 ± 12.090 mg/dl. There was a significant statistical difference before and after treatment where the p value was <0.001. While patients in group II had LDL before treatment ranging between 60 and 140 mg/dl with a mean of 91.140 ± 23.844 mg/dl, LDL after treatment ranging between 60 and 128 mg/dl with a mean of 93.760 ± 15.491 mg/dl, there was no significant statistical difference between before and after treatment where the p value was 0.312. There was a significant statistical difference as regards LDL between the two groups before treatment, where the p value was <0.001, but there was no significant statistical difference after treatment, where the p value was 0.869.

Table 6 Comparison between each group before and after treatment and the two studied groups according to LDL Level

Table 7 describes and compares each group before and after treatment with DAAs and the two groups as regards the FBS of the study population. Patients in group I had FBS before treatment ranging between 3.8 and 6.7 mmol/L with a mean of 5.448 ± 0.771 mmol/L, FBS after treatment ranged between 4.3 and 6.7 mmol/L with a mean of 5.290 ± 0.602 mmol/L, there was no significant statistical difference before and after treatment where the p value was 0.066. While patients in group II had FBS before treatment ranging between 4.2 and 6.5 mmol/L with a mean of 5.176 ± 0.613 mmol/L and FBS after treatment ranging between 4.3 and 6.2 mmol/L with a mean of 5.204 ± 0.422 mmol/L, there was no significant statistical difference between before and after treatment where the p value was 0.699. There was a significant statistical difference as regards FBS between the two groups before treatment, where the p value was 0.054 but there was no significant statistical difference after treatment, where the p value was 0.410.

Table 7 Comparison between each group before and after treatment and the two studied groups according to fasting blood sugar

Table 8 describes and compares each group before and after treatment with DAAs and the two groups as regards the fasting insulin level of the study population. Patients in group I had fasting Insulin before treatment ranged between 4 and 19 mIU/L with a mean of 11.480 ± 3.315 mIU/L, fasting insulin after treatment ranged between 5 and 16 mIU/L with a mean of 9.720 ± 2.214 mIU/L. There was a significant statistical difference before and after treatment where the p value was <0.001. While patients in group II had fasting Insulin before treatment ranging between 3 and 14 mIU/L with a mean of 7.620 ± 3.109 mIU/L, fasting Insulin after treatment ranging between 3 and 13 mIU/L with a mean of 8.220 ± 2.582 mIU/L, there was no significant statistical difference between before and after treatment where the p value was 0.122. There was a significant statistical difference as regards fasting insulin between the two groups where the p value was <0.001 before treatment and 0.002 after treatment.

Table 8 Comparison between each group before and after treatment and the two studied groups according to fasting insulin level

Table 9 describes and compares each group before and after treatment with DAAs and the two groups as regards the HOMA-IR of the study population. Patients in group I had HOMA-IR before treatment ranging between 0.67 and 4.9 with a mean of 2.795 ± 0.999 and HOMA-IR after treatment ranging between 1 and 4.5 with a mean of 2.263 ± 0.691. There was a significant statistical difference before and after treatment where the p value was <0.001. While patients in group II had HOMA-IR before treatment ranging between 0.6 and 4 with a mean of 1.794 ± 0.895 and HOMA-IR after treatment ranging between 0.6 and 3 with a mean of 1.918 ± 0.670, there was no significant statistical difference between before and after treatment where the p value was 0.277. There was a significant statistical difference concerning HOMA-IR between the two groups where the p value was <0.001, 0.013 before and after treatment, respectively.

Table 9 Comparison between each group before and after treatment and the two studied groups according to HOMA-IR

Table 10 describes and compares each group before and after treatment with DAAs and the two groups as regards the HbA1c of the study population. Patients in group I had an HbA1c before treatment ranging between 4.9 and 6.2% with a mean of 5.602 ± 0.404% and an HbA1c after treatment ranging between 4.7 and 6.2% with a mean of 5.466 ± 0.384%. There was a significant statistical difference before and after treatment where the p value was 0.003. While patients in group II had HbA1c before treatment ranging between 4.9 and 6.1% with a mean of 5.394 ± 0.372%, HbA1c after treatment ranging between 4.9 and 5.8% with a mean of 5.450 ± 0.241%, there was no significant statistical difference between before and after treatment where the p value was 0.270. There was a significant statistical difference as regards HbA1c between the two groups before treatment, where the p value was 0.009 but there was no significant statistical difference after treatment, where the p value was 0.804.

Table 10 Comparison between each group before and after treatment and the two studied groups according to HbA1c

Table 11 describes and compares each group before and after treatment with DAAs and the two groups as regards the serum adiponectin level of the study population. Patients in group I had serum adiponectin before treatment ranging between 1.5 and 30 μg/ml with a mean of 11.958 ± 7.800 μg/ml and serum adiponectin after treatment ranging between 1 and 27 μg/ml with a mean of 11.734 ± 7.793 μg/ml. There was no significant statistical difference before and after treatment where the p value was 0.764. While patients in group II had serum adiponectin before treatment ranging between 1.8 and 40 μg/ml with a mean of 15.454 ± 10.394 μg/ml, serum adiponectin after treatment ranging between 1.5 and 34 μg/ml with a mean of 13.514 ± 8.067 μg/ml, there was no significant statistical difference between before and after treatment where the p value was 0.055. There was no significant statistical difference as regard serum adiponectin between the two groups where the p value was 0.060, 0.265 before and after treatment respectively.

Table 11 Comparison between each group before and after treatment and the two studied groups according to serum adiponectin level

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