Background: HCV eradication improves both hepatic and non-hepatic outcomes, as well as metabolic disorders like insulin resistance and type 2 diabetes.

Aim: The study's purpose is to know if improved diabetic status was correlated with a reduction in systemic oxidative stress following viral eradication in diabetic HCV patients. It also aims to examine the role of systemic IFN-γ production frequency in diabetes managements, as well as its influence on insulin resistance.

Patients and methods: The following groups were formed from a total of 115 people: Group 1 consisted of 40 healthy volunteers who served as controls, and Group 2 consisted of 75 diabetic HCV-patients who received direct-acting antiviral regimen (DAA) therapy. Patients were diagnosed at baseline (before) and after therapy with sustained virologic response using laboratory testing.

Results: Generally, this study found that HCV clearance significantly ameliorates fasting blood glucose, HbA1c %, and HOMA-IR, as well as MDA, GPX activity, and GSH content, while NF-κB and Nrf2 mRNA expression levels are downregulated and upregulated, respectively. Moreover, the plasma level of IFN-γ was significantly decreased following treatment. Conclusion: The correlation between oxidative stress and viral load, as well as the reduction in MDA and improvement in antioxidant biomarkers, may have a role in diabetes and liver function improvement after HCV eradication.