Volume 8, Issue 4 (10-2020)                   JoMMID 2020, 8(4): 137-142 | Back to browse issues page

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Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
Abstract:   (524 Views)
Introduction: Hepatitis C virus (HCV) infection and type 2 Diabetes Mellitus (T2DM) are among the severe threats to health care systems worldwide. Here, we investigated the association of HCV genotypes and cirrhosis with T2DM among HCV-positive patients. Methods: This descriptive-analytical study was performed from Jan 2017 to Jan 2018 at Sina Clinical-Educational infectious diseases ward, the reference center of infectious diseases in northwest Iran. All serology HCV–positive patients attending this center were included in the study. Forty-eight patients were included, 19 of which had a positive history of diabetes. Blood samples from patients were used for complete blood count, liver function tests, fasting blood sugar, HbA1C, HCV antibodies, and HCV genotype. Then the characteristics among patients with and without T2DM were compared. A P-value of less than 0.05 was considered statistically significant. Results: No significant difference in demographic variables were observed between patients with and without T2DM. Of 48 patients with HCV infection, 29 patients (39.58%) had T2DM.  The hepatitis C infection duration among diabetic and non-diabetic patients was 9.03 ± 0.76 years and 8.53 ± 1.01 years, respectively (P = 0.04). Of 8 patients with cirrhosis, six patients (75%) had diabetes. The relative risk for diabetic patients with HCV infection to develop cirrhosis was 4.57 (95% CI [1.02-20.36], P = 0.04). The most prevalent genotype was HCV type 1 among both diabetic and non-diabetic groups. No significant association was observed in logistic regression analysis between the HCV genotypes and T2DM (P = 1.000). Conclusion: In the current study, we showed that patients with HCV infection are at a higher risk of developing T2DM, and T2DM showed to be a risk factor for the developing cirrhosis among patients with HCV infection.
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Type of Study: Original article | Subject: Infectious diseases and public health
Received: 2020/06/3 | Accepted: 2020/10/19 | Published: 2021/02/13

1. Shepard CW, Finelli L, Alter MJ. Global epidemiology of hepatitis C virus infection. Lancet Infect Dis. 2005; 5 (9): 558-67. [DOI:10.1016/S1473-3099(05)70216-4]
2. Zignego AL, Ferri C, Giannelli F, Giannini C, Caini P, Monti M, Marrocchi ME, Di Pietro E, La Villa G, Laffi G. Prevalence of bcl-2 rearrangement in patients with hepatitis C virus-related mixed cryoglobulinemia with or without B-cell lymphomas. Ann Intern Med. 2002; 137 (7): 571-80. [DOI:10.7326/0003-4819-137-7-200210010-00008]
3. Roccatello D, Fornasieri A, Giachino O, Rossi D, Beltrame A, Banfi G, Confalonieri R, Tarantino A, Pasquali S, Amoroso A. Multicenter study on hepatitis C virus-related cryoglobulinemic glomerulonephritis. Am J Kidney Dis. 2007; 49 (1): 69-82. [DOI:10.1053/j.ajkd.2006.09.015]
4. Raslan H, Ezzat W, Abdel Hamid M, Emam H, Amre K. Skin manifestations of chronic hepatitis C virus infection in Cairo, Egypt. East Mediterr Health J. 2009; 15 (3): 692-700. [DOI:10.26719/2009.15.3.692]
5. Özyilkan E, Erbas T, Simsek H, Telatar F, Kayhan B, Telatar H. Increased prevalence of hepatitis C virus antibodies in patients with diabetes mellitus. J Intern Med. 1994; 235 (3): 283-4. [DOI:10.1111/j.1365-2796.1994.tb01075.x]
6. Shintani Y, Fujie H, Miyoshi H, Tsutsumi T, Tsukamoto K, Kimura S, Moriya K, Koike K. Hepatitis C virus infection and diabetes: direct involvement of the virus in the development of insulin resistance. Gastroenterology. 2004; 126 (3): 840-8. [DOI:10.1053/j.gastro.2003.11.056]
7. Lecube A, Hernández C, Genescà J, Esteban JI, Jardí R, Simó R. High prevalence of glucose abnormalities in patients with hepatitis C virus infection: a multivariate analysis considering the liver injury. Diabetes Care. 2004; 27 (5): 1171-5. [DOI:10.2337/diacare.27.5.1171]
8. Beilby J. Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Clin Biochem Rev. 2004; 25 (3): 195.
9. Negro F, Alaei M. Hepatitis C virus and type 2 diabetes. World J Gastroenterol. 2009; 15 (13): 1537. [DOI:10.3748/wjg.15.1537]
10. Giordanino C, Bugianesi E, Smedile A, Ciancio A, Abate ML, Olivero A, Pellicano R, Cassader M, Gambino R, Bo S. Incidence of type 2 diabetes mellitus and glucose abnormalities in patients with chronic hepatitis C infection by response to treatment: results of a cohort study. Am J Gastroenterol. 2008; 103 (10): 2481. [DOI:10.1111/j.1572-0241.2008.02002.x]
11. Harris EH. Elevated liver function tests in type 2 diabetes. Clin Diabetes. 2005; 23 (3): 115-9. [DOI:10.2337/diaclin.23.3.115]
12. Arase Y, Kobayashi M, Suzuki F, Suzuki Y, Kawamura Y, Akuta N, Kobayashi M, Sezaki H, Saito S, Hosaka T. Effect of type 2 diabetes on risk for malignancies includes hepatocellular carcinoma in chronic hepatitis C. Hepatology. 2013; 57 (3): 964-73. [DOI:10.1002/hep.26087]
13. Huang J-F, Dai C-Y, Hwang S-J, Ho C-K, Hsiao P-J, Hsieh M-Y, Lee L-P, Lin Z-Y, Chen S-C, Hsieh M-Y. Hepatitis C viremia increases the association with type 2 diabetes mellitus in a hepatitis B and C endemic area: an epidemiological link with virological implication. Am J Gastroenterol. 2007; 102 (6): 1237. [DOI:10.1111/j.1572-0241.2007.01181.x]
14. Knobler H, Schihmanter R, Zifroni A, Fenakel G, Schattner A. Increased risk of type 2 diabetes in noncirrhotic patients with chronic hepatitis C virus infection. In proceedings: Mayo Clin Proc. 2000; 355-9. [DOI:10.4065/75.4.355]
15. González V, Gomes-Fernandes M, Bascuñana E, Casanovas S, Saludes V, Jordana-Lluch E, Matas L, Ausina V, Martró E. Accuracy of a commercially available assay for HCV genotyping and subtyping in the clinical practice. J Clin Virol. 2013; 58 (3): 593-7. 16. Nakatani SM, Santos CA, Riediger IN, Krieger MA, Duarte CA, Lacerda MA, Biondo AW, Carilho FJ, Ono-Nita SK. Development of hepatitis C virus genotyping by real-time PCR based on the NS5B region. PLoS One. 2010; 5 (4): e10150. [DOI:10.1016/j.jcv.2013.09.010]
16. Lin YJ, Shaw TWG, Yang HI, Lu SN, Jen CL, Wang LY, Wong KH, Chan SY, Yuan Y, L'Italien G. Chronic hepatitis C virus infection and the risk for diabetes: a community‐based prospective study. Liver Int. 2017; 37 (2): 179-86. [DOI:10.1111/liv.13194]
17. Mehta SH, Brancati FL, Sulkowski MS, Strathdee SA, Szklo M, Thomas DL. Prevalence of type 2 diabetes mellitus among persons with hepatitis C virus infection in the United States. Ann Intern Med. 2000; 133 (8): 592-9. [DOI:10.7326/0003-4819-133-8-200010170-00009]
18. Mehta SH, Brancati FL, Strathdee SA, Pankow JS, Netski D, Coresh J, Szklo M, Thomas DL. Hepatitis C virus infection and incident type 2 diabetes. Hepatology. 2003; 38 (1): 50-6. [DOI:10.1053/jhep.2003.50291]
19. Wang C-S, Wang S-T, Yao W-J, Chang T-T, Chou P. Hepatitis C virus infection and the development of type 2 diabetes in a community-based longitudinal study. Am J Epidemiol. 2007; 166 (2): 196-203. [DOI:10.1093/aje/kwm061]
20. Montenegro L, De Michina A, Misciagna G, Guerra V, Di Leo A. Virus C hepatitis and type 2 diabetes: a cohort study in southern Italy. Am J Gastroenterol. 2013; 108 (7): 1108. [DOI:10.1038/ajg.2013.90]
21. Goran MI, Ulijaszek SJ, Ventura EE. High fructose corn syrup and diabetes prevalence: a global perspective. Glob Public Health. 2013; 8 (1): 55-64. [DOI:10.1080/17441692.2012.736257]
22. Antonelli A, Ferri C, Fallahi P, Pampana A, Ferrari SM, Goglia F, Ferrannini E. Hepatitis C virus infection: evidence for an association with type 2 diabetes. Diabetes Care. 2005; 28 (10): 2548-50. [DOI:10.2337/diacare.28.10.2548]
23. Hsu YC, Lin JT, Ho HJ, Kao YH, Huang YT, Hsiao NW, Wu MS, Liu YY, Wu CY. Antiviral treatment for hepatitis C virus infection is associated with improved renal and cardiovascular outcomes in diabetic patients. Hepatology. 2014; 59 (4): 1293-302. [DOI:10.1002/hep.26892]
24. Farshadpour F, Taherkhani R, Ravanbod MR, Eghbali SS. Prevalence and genotype distribution of hepatitis C virus infection among patients with type 2 diabetes mellitus. Med Princ Pract. 2018; 27 (4): 308-16. [DOI:10.1159/000488985]
25. Ruhl CE, Menke A, Cowie CC, Everhart JE. Relationship of hepatitis C virus infection with diabetes in the US population. Hepatology. 2014; 60 (4): 1139-49. [DOI:10.1002/hep.27047]
26. Cuadros DF, Miller FD, Nagelkerke N, Abu-Raddad LJ. Association between HCV infection and diabetes type 2 in Egypt: is it time to split up? Ann Epidemiol. 2015; 25 (12): 918-23. [DOI:10.1016/j.annepidem.2015.09.005]
27. Tellez-Avila FI, Sanchez-Avila F, García-Saenz-de-Sicilia M, Chavez-Tapia NC, Franco-Guzman AM, Lopez-Arce G,
28. Cerda-Contreras E, Uribe M. Prevalence of metabolic syndrome, obesity and diabetes type 2 in cryptogenic cirrhosis. World J Gastroenterol. 2008; 14 (30): 4771. [DOI:10.3748/wjg.14.4771]
29. Gupte P, Amarapurkar D, Agal S, Baijal R, Kulshrestha P, Pramanik S, Patel N, Madan A, Amarapurkar A. Non‐alcoholic steatohepatitis in type 2 diabetes mellitus. J Gastroenterol Hepatol. 2004; 19 (8): 854-8. [DOI:10.1111/j.1440-1746.2004.03312.x]
30. Chalasani N, Younossi Z, Lavine JE, Diehl AM, Brunt EM, Cusi K, Charlton M, Sanyal AJ. The diagnosis and management of non‐alcoholic fatty liver disease: Practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Hepatology. 2012; 55 (6): 2005-23. [DOI:10.1002/hep.25762]
31. Garcia-Compean D, Jaquez-Quintana JO, Gonzalez-Gonzalez JA, Maldonado-Garza H. Liver cirrhosis and diabetes: risk factors, pathophysiology, clinical implications and management. World J Gastroenterol. 2009; 15 (3): 280. [DOI:10.3748/wjg.15.280]
32. Lee WG, Wells CI, McCall JL, Murphy R, Plank LD. Prevalence of diabetes in liver cirrhosis: A systematic review and meta‐analysis. Diabetes Metab Res Rev. 2019; 35 (6): e3157. [DOI:10.1002/dmrr.3157]
33. Stumvoll M, Goldstein BJ, van Haeften TW. Type 2 diabetes: principles of pathogenesis and therapy. Lancet. 2005; 365 (9467): 1333-46. [DOI:10.1016/S0140-6736(05)61032-X]
34. Wändell PE, Carlsson AC. Gender differences and time trends in incidence and prevalence of type 2 diabetes in Sweden-a model explaining the diabetes epidemic worldwide today? Diabetes Res Clin Pract. 2014; 106 (3): e90-e2. [DOI:10.1016/j.diabres.2014.09.013]
35. Fujita K, Oura K, Yoneyama H, Shi T, Takuma K, Nakahara M, Tadokoro T, Nomura T, Morishita A, Tsutsui K. Albumin-bilirubin score indicates liver fibrosis staging and prognosis in patients with chronic hepatitis C. Hepatol Res. 2019; 49 (7): 731-42. [DOI:10.1111/hepr.13333]
36. Kadla SA, Shah NA, Pathania R, Khan BA, Mir SA, Shah AI, Sheikh SA. prevalence of diabetes mellitus in newly detected patients with hepatitis C. J Diabetol. 2020; 11 (2): 101.
37. Mason AL, Lau JY, Hoang N, Qian K, Alexander GJ, Xu L, Guo L, Jacob S, Regenstein FG, Zimmerman R. Association of diabetes mellitus and chronic hepatitis C virus infection. Hepatology. 1999; 29 (2): 328-33. [DOI:10.1002/hep.510290235]