Islet cell and thyroid antibody prevalence in patients with hepatitis C virus infection: Effect of treatment with interferon

Piquer, Sandra; Hernández, Cristina; Enríquez, Jaime; Ross, Annemieke; Esteban, J.Ignaci; Genescà, Joan; Bonifacio, Ezio; Puig-Domingo, Manel; Simó, Rafael

doi:10.1067/mlc.2001.111515

Cited by 43 publications

(28 citation statements)

References 30 publications

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“…It might then be thought that HCV could trigger an immune reaction against the ␤-cell, which leads to diabetes. However, none of the studies that have examined the presence of islet cell antibodies in HCVinfected patients have found an increased frequency (23)(24)(25)(26)(27). In addition, we have recently demonstrated that an impairment in insulin secretion is not a primary mechanism accounting for diabetes associated with HCV infection (13).…”

Section: Discussionmentioning

confidence: 99%

Sustained Virological Response Correlates With Reduction in the Incidence of Glucose Abnormalities in Patients With Chronic Hepatitis C Virus Infection

et al. 2006

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OBJECTIVE -There is evidence to suggest that hepatitis C virus (HCV) infection is a highrisk condition for developing type 2 diabetes. However, there are no interventional studies that confirm that HCV infection causes diabetes. The main aim of this study was to compare the incidence of glucose abnormalities (diabetes plus impaired fasting glucose) between HCVinfected patients with or without sustained virological response (SVR) after antiviral therapy.RESEARCH DESIGN AND METHODS -Patients with normal fasting glucose (Ͻ100 mg/dl) with biopsy-proven chronic hepatitis C without cirrhosis and with at least 3 years of follow-up after finishing antiviral therapy were included in the study (n ϭ 234). Patients received interferon ␣-2b (alone or with ribavirin) for 6 or 12 months according to genotype. Cumulative incidence of glucose abnormalities was evaluated by using the Kaplan-Meier method comparing subjects with and without a SVR to antiviral treatment. A multivariate Cox proportional hazards analysis was performed to explore the variables independently associated with the development of glucose abnormalities.RESULTS -During follow-up, 14 of 96 (14.6%) patients with SVR and 47 of 138 (34.1%) nonsustained responders developed glucose abnormalities (P ϭ 0.001). Patients with SVR did not develop diabetes during follow-up, whereas nine cases of diabetes were detected in nonsustained responders (P ϭ 0.007). After adjustment for the recognized predictors of type 2 diabetes, the hazard ratio for glucose abnormalities in patients with SVR was 0.48 (95% CI [0.24 -0.98], P ϭ 0.04).CONCLUSIONS -Our results provide evidence that eradication of HCV infection significantly reduces the incidence of glucose abnormalities in chronic hepatitis C patients. In addition, this study supports the concept that HCV infection causes type 2 diabetes. Diabetes Care 29:2462-2466, 2006L arge community-based studies have found a strong association between hepatitis C virus (HCV) infection and type 2 diabetes (1,2), two common disorders that cause devastating longterm complications in a significant number of patients. In addition, a high prevalence of both diabetes and impaired fasting glucose (IFG), an early predictor of diabetes, has been reported in patients with chronic hepatitis C compared with other chronic liver diseases (3-7). Furthermore, in HCV-infected patients with chronic hepatitis and normal transaminases, we have detected a fivefold higher prevalence of diabetes than that found in anti-HCV-negative patients (24 vs. 5%, P ϭ 0.003) (7). Therefore, it seems that the genuine connection between HCV infection and diabetes is initiated at the early stages of hepatic disease.HCV infection is characterized by a silent onset in most infected individuals, and recent studies (8 -10) indicate that the rate of progression to advanced liver disease is lower than previously assumed. Salomon et al. (10) estimated the median duration between infection and cirrhosis to be 46 years for men infected at age 25 years, whereas in a cohort of women infecte...

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Section: Discussionmentioning

confidence: 99%

Sustained Virological Response Correlates With Reduction in the Incidence of Glucose Abnormalities in Patients With Chronic Hepatitis C Virus Infection

et al. 2006

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“…Few data on this association have been reported, and published studies have shown only small proportions of CHC patients positive for one or more markers of pancreatic autoimmunity [18,[147][148][149][150] . Even rarer are reports on the potential association between autoimmune diabetes and acute HCV infection.…”

Section: Hcv-infected Patients With T1dmmentioning

confidence: 99%

“…Fabris et al [189] documented the first case of T1DM development during IFN-α therapy. Other studies suggest that IFN-α therapy can stimulate pancreatic autoimmunity and, in certain cases, lead to the development of T1DM [150,175,177,180,181, . The relationship with T1DM does not account for all of the effects of IFN-α therapy on diabetes.…”

Section: T1dm and T2dm In Hcv-infected Patients Treated With Ifn-αmentioning

confidence: 99%

Hepatitis C virus infection and type 1 and type 2 diabetes mellitus

Antonelli

Ferrari

Giuggioli

et al. 2014

WJD

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cytokines, chemokines, and other immune-mediated mechanisms. Few data have been reported on the association of CHC and T1DM and reports on the potential association between T1DM and acute HCV infection are even rarer. A small number of studies indicate that interferon-α therapy can stimulate pancreatic autoimmunity and in certain cases lead to the development of T1DM. Diabetes and CHC have important interactions. Diabetic CHC patients have an increased risk of developing cirrhosis and hepatocellular carcinoma compared with non-diabetic CHC subjects. However, clinical trials on HCV-positive patients have reported improvements in glucose metabolism after antiviral treatment. Further studies are needed to improve prevention policies and to foster adequate and cost-effective programmes for the surveillance and treatment of diabetic CHC patients. AbstractHepatitis C virus (HCV) infection and diabetes mellitus are two major public health problems that cause devastating health and financial burdens worldwide. Diabetes can be classified into two major types: type 1 diabetes mellitus (T1DM) and T2DM. T2DM is a common endocrine disorder that encompasses multifactorial mechanisms, and T1DM is an immunologically mediated disease. Many epidemiological studies have shown an association between T2DM and chronic hepatitis C (CHC) infection. The processes through which CHC is associated with T2DM seem to involve direct viral effects, insulin resistance, proinflammatory Submit a

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“…However, serious doubt concerning the true character of diabetes in HCV patients must be emphasized. An autoimmune basis of the HCV-diabetes link is unlikely because no increased prevalence of ␤-cell autoimmune markers in HCV patients has been found (2). Nonetheless, there is a report of type 1 diabetes 1 year after blood transfusion-related HCV infection (3).…”

Section: Hepatitis C Virus Infection: Evidence For An Association Witmentioning

confidence: 99%

“…The most commonly used method to increase androgen levels in aging, hypogonadal men is to administer testosterone supplementation therapy (2). From a urological perspective, a major problem with the use of testosterone supplementation alone in aging men is that the exogenously administered testosterone is metabolized by 5␣-reductase to dihydrotestosterone (DHT).…”

mentioning

confidence: 99%

Relationship Between Testosterone Levels, Insulin Sensitivity, and Mitochondrial Function in Men

Hayes¹

2006

Diabetes Care

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Islet cell and thyroid antibody prevalence in patients with hepatitis C virus infection: Effect of treatment with interferon

Cited by 43 publications

References 30 publications

Sustained Virological Response Correlates With Reduction in the Incidence of Glucose Abnormalities in Patients With Chronic Hepatitis C Virus Infection

Sustained Virological Response Correlates With Reduction in the Incidence of Glucose Abnormalities in Patients With Chronic Hepatitis C Virus Infection

Hepatitis C virus infection and type 1 and type 2 diabetes mellitus

Relationship Between Testosterone Levels, Insulin Sensitivity, and Mitochondrial Function in Men

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