Abstract

BackgroundThe highest Hepatitis C Virus (HCV) prevalence in the world occurs in Egypt. Several studies from different parts of the world have found that 13% to 33% of patients with chronic HCV have associated diabetes, mostly type II Diabetes Mellitus (DM). In Egypt the prevalence of DM is 25.4% among HCV patients. Therefore, it is important to identify the magnitude of the problem of diabetes in order to optimize the treatment of chronic hepatitis C.MethodsThe objective of this case-control study was to evaluate the prevalence of DM and other extrahepatic (EH) manifestations among patients with different HCV morbidity stages including asymptomatic, chronic hepatic and cirrhotic patients. In this study, 289 HCV patients older than 18 were selected as cases. Also, 289 healthy controls were included. Laboratory investigations including Liver Function tests (LFT) and blood glucose level were done. Also serological assays including cryoglobulin profile, rheumatoid factor, antinuclear antibody, HCV-PCR were performed.ResultsOut of 289 HCV cases, 40 (13.84%) were diabetic. Out of 289 healthy controls, 12 (4.15%) were diabetic. It was found that the diabetic HCV group mean age was [48.1 (± 9.2)]. Males and urbanians represented 72.5% and 85% respectively. Lower level of education was manifested in 52.5% and 87.5% were married. In the nondiabetic HCV group mean age was [40.7 (± 10.4)]. Males and urbanians represented 71.5% and 655% respectively. secondary and higher level of education was attained in 55.4% and 76.7% were married. Comparing between the diabetic HCV group and the non diabetic HCV group, age, residence and alcohol drinking were the only significant factors affecting the incidence of diabetes between the two groups. There was no significant difference regarding sonar findings although cirrhosis was more prevalent among diabetic HCV cases and the fibrosis score was higher in diabetic HCV patients than among the non diabetic HCV cases.ConclusionThe diabetic patients in the HCV group were older, more likely to have a history of alcohol drinking than the non diabetic HCV cases. Age and alcohol drinking are factors that could potentially contribute to the development of type 2 diabetes. Logistic regression analyses showed that age and residence in urban regions were the predictive variables that could be associated with the presence of diabetes. Alcohol consumption was not a significant predictive factor.

Highlights

  • The highest Hepatitis C Virus (HCV) prevalence in the world occurs in Egypt

  • Based on case-control studies, the prevalence of Diabetes Mellitus (DM) had been reported in 21% to 50% of patients with chronic HCV infection, which was significantly higher than that in the general population or among patients with other forms of liver diseases [21]

  • That was consistent with a study on a large cohort of patients conducted by Lecube and coworkers [25]. Taken together these findings suggest that HCV infection is a more important predictor of glucose intolerance than cirrhosis, and the combination of both factors further increases the risk of diabetes

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Summary

Introduction

The highest Hepatitis C Virus (HCV) prevalence in the world occurs in Egypt. Several studies from different parts of the world have found that 13% to 33% of patients with chronic HCV have associated diabetes, mostly type II Diabetes Mellitus (DM). In Egypt the prevalence of DM is 25.4% among HCV patients. The highest Hepatitis C Virus (HCV) prevalence in the world occurs in Egypt at an estimated 12% among the general population [1] and reaches 40% in persons 40 years of age and above in rural areas [2]. Extrahepatic (EH) manifestations associated with HCV infection include endocrinological manifestations such as diabetes mellitus (DM) [6] and thyroiditis [7], rheumatologic manifestations such as arthralgias, arthritis [8] and mixed cryoglobulinemia [9]. An awareness and recognition of these manifestations is of paramount importance in facilitating early diagnosis and management of these complications [10]

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