Viral Hepatitis

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

  1. Yasuji Arase‡,*,
  2. Fumitaka Suzuki,
  3. Yoshiyuki Suzuki,
  4. Norio Akuta,
  5. Masahiro Kobayashi,
  6. Yusuke Kawamura,
  7. Hiromi Yatsuji,
  8. Hitomi Sezaki,
  9. Tetsuya Hosaka,
  10. Miharu Hirakawa,
  11. Kenji Ikeda,
  12. Hiromitsu Kumada

Article first published online: 24 OCT 2008

DOI: 10.1002/hep.22703

Issue

Hepatology

Hepatology

Volume 49, Issue 3, pages 739–744, March 2009

Additional Information

How to Cite

Arase, Y., Suzuki, F., Suzuki, Y., Akuta, N., Kobayashi, M., Kawamura, Y., Yatsuji, H., Sezaki, H., Hosaka, T., Hirakawa, M., Ikeda, K. and Kumada, H. (2009), Sustained virological response reduces incidence of onset of type 2 diabetes in chronic hepatitis C. Hepatology, 49: 739–744. doi: 10.1002/hep.22703

Author Information

  1. Department of Hepatology, Toranomon Hospital, Tokyo, Japan

  1. ‡

    fax: (81)-3-3582-7068.

*Department of Hepatology, Toranomon Hospital, 2-2-2, Toranomon, Minato-ku, Tokyo 105-8470, Japan

  1. †

    Potential conflict of interest: Nothing to report.

Publication History

  1. Issue published online: 24 FEB 2009
  2. Article first published online: 24 OCT 2008
  3. Accepted manuscript online: 24 OCT 2008 12:00AM EST
  4. Manuscript Accepted: 13 OCT 2008
  5. Manuscript Received: 25 SEP 2008

Funded by

  • Okinaka Memorial Institute for Medical Research
  • Japanese Ministry of Health, Labor, and Welfare

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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.)

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