Associação entre a hepatite crônica pelo vírus da hepatite C (VHC) e diabete melito em pacientes monoinfectados pelo VHC e co-infectados com o vírus da imunodeficiência humana / Association between the chronic infection by hepatitis C virus (HCV) and diabetes mellitus in patients monoinfected with the HCV and coinfected with the human immunodeficiency virus

RESUMO

O objetivo deste estudo é estimar a prevalência de diabete melito (DM) em pacientes portadores de hepatite crônica pelo vírus da hepatite C (VHC) e naqueles co-infectados por VHC/HIV. Foram avaliados dois grupos um com pacientes monoinfectados por VHC e outro com pacientes co-infectados por VHC/HIV. Foram avaliados idade, gênero e cor da pele. Nos monoinfectados foi calculado o índice de massa corporal (IMC). Foram realizados aminotransferases, albumina, bilirrubina total, tempo de protrombina e genotipagem do VHC. A biópsia hepática foi realizada em todos os pacientes. Foram avaliados 135 pacientes monoinfectados, dos quais 30 (22,2%) apresentavam DM, e 117 pacientes co-infectados, sendo 35 (29,9%) com DM (p=0,164). A média geral de idade nos monoinfectados foi de 48,28 ± 9,68 anos, superior ao grupo de co-infectados (40,83 ± 9,01 anos). Na avaliação dos dois grupos houve predomínio do gênero masculino. A maioria dos pacientes apresentava pele de cor branca. Avaliando-se o IMC, observou-se distribuição uniforme, com predomínio de IMC acima de 25 kg/m2, independente da presença de DM. Quando avaliados os exames laboratoriais, observou-se que as aminotransferases foram significativamente mais alteradas naqueles pacientes sem DM. Os demais exames não demonstraram diferenças significativas entre os grupos. Houve maior prevalência de genótipo 2 ou 3, sendo que dentre aqueles co-infectados observou-se correlação entre estes e a presença de DM. Quanto à fibrose, houve predomínio de F3/F4 naqueles com DM. Em conclusão, a prevalência de DM nos pacientes monoinfectados pelo VHC e nos co-infectados por VHC/HIV é alta (AU)

ABSTRACT

The aim of this study was to estimate the prevalence of Diabeters Mellitus (DM) in chronically HCV infected patients and in those coinfected by HCV/HIV. Two groups were evaluated one infected with HCV virus and the other with co-infection HCV/HIV. The patients in both groups were evaluated for age, gender and skin color. In the monoinfected group the body mass index (BMI) was calculated. Aminotransferases, albumin, total bilirrubin, protrombin time and HCV genotyping were performed. Liver biopsy was performed in all patients. Thirty (22.2%) of 135 monoinfected patients had DM. DM was observed in 35 (29.9%) of 117 co-infected patients (p=0,164). The age in the monoinfected group was 48.28 ± 9.68 years. It was higher than the co-infected group (40.83 ± 9.01 years). In both groups there was a predominance of males and most patients were white. Regarding BMI it was an uniform distribution and BMI higher than 25 Kg/m2 was more frequent. The aminotransferases were significantly higher in those patients without DM. The other exams did not show significant differences between the groups.There was a higher prevalence of genotype 2 or 3. Among the co-infected a correlation was observed between these genotypes and the presence of DM. Liver biopsy showed a predominance of F3/F4 in those with DM. In conclusion, the prevalence of DM in the HCV monoinfected patients and in those co-infected HCV/HIV is high (AU)