incidence of HCV infection among type-II diabetic patients, is there an association?

ABSTRACT

To study the relationship between diabetes mellitus [DM] and hepatitis C virus [HCV] infection, this study included 200 diabetic patients of type 2 and 185 apparently healthy blood donors as their controls. It included also 50 diabetic patients of type 1 and 42 blood donors as their controls. All patients and their controls were age and sex matched. Patients were attendants of Diabetic Out-Patients Clinic, Faculty of Medicine Menoufiya University. Fasting and postprandial blood glucose levels, glycosylated haemoglobin [Hb Al[c]], kidney function tests, liver function tests, viral hepatitis markers [hepatitis B surface antigen, HBs Ag and anti-HCV antibodies] were performed for all studied subjects. All anti-HCV positive cases were evaluated for HCV viraemia by RT-PCR for HCV-RNA. On comparing results of type 2 diabetic patients with their controls, results revealed a significant high prevalence of anti-HCV seropositivity in patients group as 67 out of 200 patients [33.5%] were anti-HCV seropositive vs. 32/185 [17.3%] in their controls [p<0.01]. It was found that 55/67 [82.1%] of anti-HCV positive cases were also HCV-RNA positive. HBs Ag seropositivity was significantly higher among type 2 DM [15.5% of 200 patients vs. 4.3% of 185 controls, p<0.01]. Statistically significant differences [p<0.01] in the levels of ALT and AST were observed between HCV-seropositive and HCV-seronegative patients with type 2 DM. Blood urea and serum creatinine showed significant elevated values [p<0.01] among type 2 diabetic patients. No significant correlation was observed between HCV-seropositivity and glycaemic control [Hb Alc]. In type 1 DM there was a significant high prevalence of anti-HCV seropositivity [42% of 50 patients vs. 19.04% of 42 controls, p<0.01]. It could be concluded that both HBV and HCV infections are equally frequent in diabetes; therefore, diabetes mellitus is considered as an important risk factor for acquiring chronic liver disease. These findings, although suggestive, don't establish a cause and effect relationship and are not consistent with the conjecture that diabetes leads to HCV infection, but instead favor hypothesis suggesting that persistent HCV infection is associated with the subsequent development of diabetes