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Affiliations
University of Michigan, Ann Arbor, MI Address for Correspondence:Hari Conjeevaram, M.D., M.S., Division of Gastroenterology, The University of Michigan 3912 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109, Telephone: (734) 615-4628, Facsimile: (734) 936-7392,
Abdus S. Wahed, Ph.D. Affiliations Department of Biostatistics, Graduate School of Public Health at the University of Pittsburgh, Pittsburgh, PA, Nezam Afdhal, M.D. Affiliations Beth Israel Deaconess Medical Center, Boston, MA, Charles D. Howell, M.D. Affiliations University of Maryland, Baltimore, MD,
James E. Everhart, M.D., M.P.H. Affiliations National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, Jay H. Hoofnagle, M.D. Affiliations
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD,
Virahep-C Study Group Received 30 July 2009; received in revised form 25 October 2010; accepted 3 November 2010.
Background & Aims:
Chronic hepatitis C is associated with an increased prevalence of insulin .
resistance, which might result from liver disease, metabolic factors, or the hepatitis C virus (HCV) itself. The effect of antiviral treatment on insulin sensitivity is not well known. We evaluated changes in insulin resistance and weight in patients with hepatitis C during and after peginterferon and ribavirin therapy.
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Methods:
Virahep-C was a prospective, multi-center study of a 48-week course of combination antiviral therapy in patients infected with HCV genotype 1. Insulin resistance was estimated by the homeostasis model assessment index (HOMA2-IR) based on fasting glucose and insulin levels.
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Results:
Among 341 patients, 40% had insulin resistance (HOMA2-IR > 2.0). The presence of insulin resistance was associated with increasing age, body mass index, (BMI) and fibrosis stage. Among patients with insulin resistance at the start of the trial, median decreases in HOMA2-IR values during treatment were 0.74 at 24 weeks and 0.89 at 48 weeks, whereas BMI decreased by 1.2 and 2.2 kg/m2 at the same timepoints ( P less then 0.001 for all). At follow-up, HOMA2-IR and BMI levels returned toward baseline values in patients that did not respond or relapsed, but HOMA2-IR values remained significantly lower in patients with sustained virological response (SVR) ( P less then 0.001), despite increases in BMI.
In patients with HCV genotype 1 infections, therapy with peginterferon and ribavirin is associated with decreases in body weight and insulin resistance. Among patients with insulin resistance before treatment, resolution of HCV infection results in sustained improvements in the homeostasis model assessment index, so HCV could have a direct role in the pathogenesis of insulin resistance.
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Abstract From Nov 5th.
Seroprevalence of Hepatitis C in type 2 diabetes: Evidence for a positive association
Nauman A Jadoon, Mohammad A Shahzad, Rehan Yaqoob, Mansoor Hussain and Naseema Ali
Virology Journal 2010, 7:304 doi:10.1186/1743-422X-7-304
Published: 5 November 2010
Abstract (provisional)
type 2 diabetes mellitus= (T2DM).
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Background
There is a growing body of literature on the relationship of Hepatitis C virus infection (HCV) and type 2 diabetes mellitus (T2DM). However, there are certain gaps in literature and the data is inconclusive. This study was, therefore, carried out to determine the prevalence of HCV infection in diabetic patients and to elucidate the presence of any possible relationship between HCV and T2DM in this region.
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Methods
Serologic testing for anti-HCV antibody was done on a sample of 3000 individuals with type 2 diabetes mellitus *T2DM visiting Diabetes Clinic of Nishtar Medical College Hospital, Multan and 10,000 volunteer blood donors visiting blood bank of the same hospital during the study period using Accurate rapid immunochromatographic kits which was later confirmed by using Chemelex S.A third generation ELISA kit for positive cases. Data about various variables was collected from diabetic patients using a structured questionnaire after taking informed consent.
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Results
Prevalence rate of 13.7% for HCV infection was recorded among subjects having T2DM with seropositivity rate of 4.9% among the control group of volunteer blood donors without diabetes. The patients with T2DM were more likely to have HCV infection as compared to the control group (OR= 3.03, 95%CI= 2.64-3.48, p= 0.001).
Diabetic patients with age above 55 years had higher prevalence rate as compared to younger individuals.
Male patients had significantly high seropositivity as compared to female patients (15.3% vs. 12.4%, p=0.02). Those with duration of diabetes 11 years and above and the ones with good glycemic control had higher seroprevalence rates of 18.2% and 18.7% respectively. There was no statistically significant difference among subjects when the distribution of HCV was studied on the basis of marital status, locality, or family history of diabetes.
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Conclusions
The results show that there is a strong association between HCV and T2DM in the region as evident from significantly higher prevalence of HCV infection in diabetics as compared to the control group in the present study.
The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.
Also See : Liver hormone is a cause of insulin resistance
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