Clinical and Metabolic Features of Chronic Hepatitis C Depending on Viral Genotype

The progression of chronic hepatitis C virus (HCV) infection is closely associated with metabolic disturbances, particularly insulin resistance and type 2 diabetes mellitus. This study aimed to evaluate the influence of HCV genotypes on carbohydrate metabolism, lipid metabolism, and the functional-structural state of the liver in patients with chronic hepatitis C (CHC). The study included 90 patients with CHC. According to HCV genotype, patients were divided into three groups: genotype 1b, genotype 2, and genotype 3a. Genotype 1b was identified in 59 patients (65.5%), genotype 2 in 5 patients (5.5%), and genotype 3a in 26 patients (28.9%). Carbohydrate metabolism parameters, anthropometric indices, lipid profile indicators, liver transaminases, ultrasound findings, and liver fibrosis assessed by transient elastography (FibroScan) were analyzed comparatively among genotype groups. Patients with genotype 1b demonstrated significantly higher fasting glucose, insulin levels, HOMA-IR index, and HbA1c values compared with other genotypes, indicating more pronounced insulin resistance and carbohydrate metabolism disorders. Genotype 3a patients exhibited more severe lipid metabolism disturbances characterized by elevated total cholesterol, triglycerides, low-density lipoproteins, and atherogenic index. Liver transaminases were significantly higher in genotype 3a patients compared with genotype 2 patients. Advanced liver fibrosis stages (F3–F4) were predominantly observed in patients with genotype 1b. The findings suggest that HCV genotype significantly affects metabolic disturbances and liver fibrosis progression in CHC patients. Genotype 1b is associated mainly with impaired carbohydrate metabolism and progressive fibrosis, whereas genotype 3a is more strongly associated with dyslipidemia.

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