Until recently (see next post tomorrow), it has been well-recognized that there is a connection between chronic hepatitis C infection and diabetes mellitus (DM) (related previous post: Treating HCV Helps Diabetics | gutsandgrowth). More data confirms that the development of diabetes is associated with increased risk of poor outcomes in HCV-infected patients.
- Hepatology 2014; 60: 807-14
- Hepatology 2014; 60: 823-31
In the first study, the authors used a nation-wide cohort comprising >99% of the Taiwanese population. Among a random sample of 1 million enrollees, 6,251 adult chronic HCV patients were identified from 1997-2009. Among those who developed DM during the study period (not before), after adjustment for confounding variables, diabetes was an independent predictor for cirrhosis (hazard ratio (HR) =2.5, P<0.001) and hepatic decompensation (HR=3.56, P+0.003).
In the second study, the authors identified consecutive chronic HCV-infected patients with cirrhosis who were hospitalized between 2006-2008 (n=348). At baseline, 40% had DM. DM was independently associated with development of ascites (P=0.057), renal dysfunction (P=0.004), bacterial infections (P=0.007), and hepatocellular carcinoma (P=0.016). The authors suggest that improving diabetes control may improve the outcome of cirrhosis.
Take-home message: New-onset diabetes is a marker for progressive liver disease in patients with chronic HCV infection. Whether diabetes has a causal role in HCV patient deterioration remains unclear.
Also noted, from Healio Gastroenterology, a recent study suggests that sofusbuvir/ledipasvir reduces HCV-related complications, here’s link: Sofusbuvir/ledipasvir Abstract