Diabetes mellitus is more common in chronic hepatitis C patients and is a negative predictor for sustained virological response. Results of a study from a north-east Hungarian region

Background: The prevalence of type 2 diabetes mellitus (T2DM) is higher in chronic hepatitis C (CHC) patients compared to healthy population. Hepatitis C virus (HCV) can directly influence the intracellular insulin signaling pathway (ISP), and causes elevation in serum level of pro-inflammatory cytokins such as TNF-α or IL-6. Diabetes is considered a negative predictor for the success of the antiviral therapy.

Aim: We analyzed the prevalence of the T2DM and it's impact for the sustained virological response (SVR) and other abnormalities of carbohydrate metabolism in CHC patients from North-East Hungary (NEH).

Patients and methods: 132 CHC patients (56 male, M/76 female, F; all HCV genotype 1) were involved this retrospective study. The mean age was 48.1±8.9 (18–71) years, mean body weight 74.6±13.8kg; BMI (body mass index) 26.1±2.7; waist circumference 94.5±10.8cm (M); 85.8±11.2cm (F). Each patient was treated with pegylated interferon and ribavirin in time period 2006–2010. 81 patients was overweight (BMI>25), 31 patients had T2DM and other 20 had impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). The average HbA1c value was 7.8 in the T2DM group. All T2DM patients were on diet; 22 patients were treated with metformin, 5 with insulin and 4 had other oral antidiabetic drug therapy. Results: Overall SVR rate was 36% (M: 32%, F: 44%). In patients with >25.0 BMI the T2DM rate was 32% (26/81) while in pts. with<25.0 BMI only 16% (8/51; p<0.01). SVR rate among the diabetic patients was only 5/31 (16%) versus non-diabetic patients (41/91, 45%; p<0.01). The SVR rate in IFG/IGT group was 5/20 (25%). T2DM patients treated with metformin achieved SVR in 4/22 (18%). Patients over 25.0 BMI showed a lower SVR rate (28/81, 35%) compared to patients with normal BMI (20/51, 39%). Conclusion: High prevalence of T2DM and other abnormalities of the carbohydrate metabolism were detected in our CHC patients from the region of NEH. In concordance with other data we confirmed that the presence of T2DM or IFG/IGT and overweight are negative host predictors for sustained virological response.