Sustained virological response reduces incidence of onset of type 2 diabetes in chronic hepatitis C†

Abstract

Diabetes is present in patients with chronic hepatitis C virus infection. The aim of this retrospective cohort study was to assess the cumulative development incidence and predictive factors for type 2 diabetes after the termination of interferon therapy in Japanese patients positive for hepatitis C virus (HCV). A total of 2,842 HCV‐positive patients treated with interferon (IFN) monotherapy or combination therapy with IFN and ribavirin were enrolled. The mean observation period was 6.4 years. An overnight (12‐hour) fasting blood sample or a casual blood sample was taken for routine analyses during follow‐up. The primary goal was the onset of type 2 diabetes. Evaluation was performed by using the Kaplan‐Meier method and Cox proportional hazard analysis. Of 2,842 HCV patients, 143 patients developed type 2 diabetes. The cumulative development rate of type 2 diabetes was 3.6% at 5 years, 8.0% at 10 years, and 17.0% at 15 years. Multivariate Cox proportional hazard analysis revealed that type 2 diabetes development after the termination of IFN therapy occurred when histological staging was advanced (hazard ratio 3.30; 95% confidence interval [CI] 2.06‐5.28; P < 0.001), sustained virological response was not achieved (hazard ratio 2.73; 95% CI 1.77‐4.20; P < 0.001), the patient had pre‐diabetes (hazard ratio 2.19; 95% CI 1.43‐3.37; P < 0.001), and age was ≥50 years (hazard ratio 2.10; 95% CI 1.38‐3.18; P < 0.001). Conclusion: Our results indicate sustained virological response causes a two‐thirds reduction in the risk of type 2 diabetes development in HCV‐positive patients treated with IFN. (HEPATOLOGY 2009.)