Diabetes Mellitus Is More Commonly Associated With IL28b non-C/C Genotype Than in C/C Genotype in Patients With HCV

Abstract

Introduction: IL28b polymorphism is an important predictor for HCV response to therapy; and IL28b C/C genotype is considered to have favorable response as compared to non-C/C genotype. However, whether IL28b genotypes also influence other non-treatment related clinical parameters is not clear. Methods: In this retrospective analysis, patients with HCV related chronic liver disease attending Sir Ganga Ram Hospital, New Delhi, from 2012 to 2014 were analyzed. The SNPs rs12979860 (IL28B) was investigated by RT-PCR and IL28b genotypes were correlated with various clinical parameters. Results: A total of 115 patients were included in the study (median age 48, range 15-76 years; 70% males). The most common IL28b genotype was C/C 53% (61/115), while rest 47% were non-C/C [C/T 42% (48/115) and T/T 5% (6/115)]. Overall, 43/115 (37%) patients had chronic hepatitis, while rest 72/115 (63%) were cirrhotics (including 4 patients who had HCC). The IL28b genotype distribution was similar in chronic hepatitis and cirrhotic groups. Various clinical and laboratory parameters like Hb, WBC, platelets, bilirubin, AST, ALT, albumin, and INR levels were similar in C/C and non-C/C genotypes. Diabetes mellitus was found in 22% (25/115) of patients. Patients with non-C/C genotype had significantly higher prevalence of diabetes mellitus than patients with genotype C/C (31% [17/54] versus 13% [8/61]; p=0.023). Conclusion: Diabetes Mellitus was found to be more commonly associated with IL28b non-C/C genotype than in C/C genotype in patients with HCV. Since insulin resistance is more common in carriers of the T allele of SNP rs12979860 than in CC homozygotes, this may explain higher prevalence of diabetes in non-C/C genotypes. Thus IL28b should be tested in all patients of HCV to determine their likelihood of developing diabetes mellitus later.