Friday, April 6, 2018

Prevalence and genotype distribution of hepatitis C virus infection among patients with type 2 diabetes mellitus.

Med Princ Pract. 2018 Apr 5. doi: 10.1159/000488985. [Epub ahead of print]
Published online: April 05, 2018

Prevalence and genotype distribution of hepatitis C virus infection among patients with type 2 diabetes mellitus.
Farshadpour F, Taherkhani R, Ravanbod MR, Eghbali SS.

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In this study, the prevalence of HCV infection in the diabetic patients in southern Iran was high and it was not associated with the biochemical measurements. Genotype 3a was the only genotype found in the diabetic population of this study, and all the HCV-infected diabetic patients were unaware of the infection due to asymptomatic nature of chronic HCV infection. Therefore, screening of all diabetic patients for HCV infection should be recommended to prevent the serious consequences associated with the coexistence of these two chronic diseases in a long run.

As Noted In The Study: After genotype 1a, genotype 3a is the most prevalent genotype in Iran, which is frequently observed among young Iranian patients and intravenous drug users; while genotypes 2 and 4 are uncommon in Iran [11, 27]. Overall, it is not obvious whether HCV genotype 3a observed in the present study is responsible for the occurrence of DM or whether it merely follows the predominant genotypic pattern of HCV in the region. However, this specific genotypic pattern of HCV infection in the diabetic patients of the present study is unlikely to be ascribable to chance alone and, therefore, merits further attention.

This study was conducted to determine the prevalence and genotype distribution of HCV infection among patients with type 2 diabetes mellitus (DM).

Materials (Subjects) and Methods
A total of 556 consecutive patients with confirmed type 2 DM attending the diabetic clinic of Bushehr University of Medical Sciences and 733 non-diabetic subjects as control group were included in this study. Levels of FBS, ALT, AST, TCH and TG were measured by enzymatic colorimetric method, and the presence of anti-HCV antibodies were determined by ELISA. Semi-nested RT-PCR followed by sequencing was performed for all the anti-HCV seropositive samples. The data were analyzed using the Statistical Package for the Social Sciences 17.

Seroprevalence of HCV in diabetic patients was 1.98% (11/556), which was higher than HCV prevalence among the non-diabetic controls (4/733, 0.54%) (P=0.032). No significant differences in ALT, AST, FBS, TG and TCH levels were found between HCV seropositive and seronegative diabetic patients, although HCV seropositive diabetic patients tended to have higher ALT, AST and TCH levels but lower TG and FBS levels than seronegative patients. In the logistic regression analysis, only AST level was significantly associated with HCV seropositivity. Hence, AST level of 41-80 IU/L was the only significant predictive variable for HCV seropositivity in the diabetic patients (odds ratio, 4.89; 95% CI: 1.06-22.49; P= 0.041). Of 11 HCV seropositive diabetic patients, 10 (91%) had HCV viremia with genotype 3a.

Patients with type 2 DM had a higher prevalence of HCV infection than controls, and this HCV seropositivity was independent of biochemical parameters.

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