[Study of prevalence of hepatitis C and its relationship with impaired glucose tolerance and diabetes mellitus in beta-thalassemic patients]

ABSTRACT

Impaired glucose tolerance [IGT] and diabetes mellitus [DM] are well known complications in multitransfused beta thalassemia patients. Iron overload and chronic liver disease, viral infection and/or genetic factors may play important roles in the development of glucose intolerance. The aim of the present study is to determine the prevalence of hepatitis C and its relation with diabetes and impaired glucose tolerance. The study included 195 multitransfused beta thalassemic patients, 97 females and 98 males with a mean age of 14.9 +/- 6.07 years [range 5-36 years]. Diagnosis of DM and IGT was based on the criteria of ADA and WHO. Hepatitis markers were detected by use of ELISA test. Results were analyzed by means of Chi-square test. The results of ELISA test revealed forty [20.51%] patients were seropositive for HCV. After removal of confounding factors, serum ferritin level [p = 0.039] and hepatitis C infection [p = 0.006] were identified as independent risk factors, having significant relationship with abnormal glucose tolerance. With increasing age the number of blood transfusions increases and subsequently the possibility of iron overload and infection with hepatitis C virus increases. In our study the prevalence of diabetes in adult thalassemic patients suffering from HCV infection increased. It is probable that hemosiderosis makes the effect of HCV infection on glucose metabolism more evident clinically. Aggressive iron chelating therapy as well as prevention and treatment of hepatitis C infection are the most important measures in glucose homeostasis in transfusion dependent beta thalassemic patient