Review article: an unexpected virus–host interaction – the hepatitis C virus‐diabetes link

Abstract

SummaryThere is now consistent epidemiological evidence for an association between chronic hepatitis C and diabetes. Important, although so far limited longitudinal data, have documented an increased risk for diabetes in patients infected by hepatitis C virus (HCV) especially in those with metabolic risk factors such as a high BMI and older age. HCV encoded proteins might alter insulin signalling thus explaining impaired insulin sensitivity and the occurrence of glycaemic dysregulation even before the cirrhotic stage. The consequences of the association between diabetes and HCV infection are an increased liver fibrosis stage and faster fibrosis progression rate. This article reviews recent human and experimental data on the HCV‐diabetes association.

Associations of chronic hepatitis C with metabolic and cardiac outcomes

“…Our study shows that CH-C is independently associated with three important metabolic conditions: IR, DM and hypertension. Although the association of HCV with IR and DM has been previously reported, [18][19][20][21][22][23][24] the association of HCV with hypertension is a novel finding. 3,4 In fact, in one of our previous population-based studies, 21 we reported that the association of HCV with IR and DM might have been attenuated in the last decade by the epidemics of obesity.…”

“…In fact, HCV has been shown to affect glucose-insulin homeostasis as well as lipid metabolism and lipid synthesis. [7][8][9][10][11][12]18 In addition, viral factors such as HCV genotypes and HCV core protein can have a direct impact on these interactions. 12 These are significant evidence to support the notion that HCV predisposes patients to insulin resistance and possibly other metabolic abnormalities with their potential consequences such as cardiovascular diseases.…”

Hepatitis C Infection and Chronic Renal Diseases

“…HCV-positive patients with and without cirrhosis have elevated levels of fasting serum insulin and insulin resistance, and higher prevalence of diabetes (reviewed in (23)). HCV core protein directly reduces expression of insulin receptor substrate proteins (IRS) 1 and 2 (24), responsible for metabolic effects of insulin, and promotes activation of IRS-1 and high expression of TNF-␣ at least in hepatic cells (25).…”

Influence of Diabetes on Circulating Apoptotic Microparticles in Patients with Chronic Hepatitis C

“…Of these, there is increasing evidence that CHC infection increases the risk for insulin resistance and type 2 diabetes mellitus (DM) (1,2). The association between hepatitis C virus (HCV) and type 2 diabetes has been shown to be related both to the host factors as well as viral factors (3). In fact, HCV has been shown to affect glucose-insulin homeostasis and lipid metabolism.…”

“…In fact, HCV has been shown to affect glucose-insulin homeostasis and lipid metabolism. In addition, viral factors (HCV genotypes and HCV core protein) can have a direct impact on these interactions (3). There are significant evidences to support the notion that HCV predisposes patients to type 2 diabetes and also the burden of cardiovascular diseases increases in CHC patients (4,5).…”