• Potential conflict of interest: Nothing to report.


We are pleased with the interest in our article1 and appreciate the useful comments made by Dr. Tugrul Purnak. He eloquently discussed the onset of diabetes mellitus. We agree with Dr. Tugrul Purnak. The aim of this retrospective cohort study was to assess the cumulative development incidence and predictive factors of type 2 diabetes after the termination of interferon therapy in hepatitis C virus–positive patients. In the present study, we wanted to determine whether the clearance of hepatitis C virus reduces the risk of type 2 diabetes development. Unfortunately, in this study, we could not evaluate the smoking status, family history of diabetes, hypertension, apolipoprotein, or genetic factors.

With respect to changes in the body mass index (BMI), some patients experiencing the onset of diabetes were measured during follow-up, as shown in Table 1. In patients without a sustained virological response, the BMI was almost the same. On the other hand, in patients with a sustained virological response, the mean BMI increased by about 1.0.This means that in patients without a sustained virological response, the onset of diabetes is enhanced without an increase in the BMI.

Table 1. Changes in the BMI of Patients with the Onset of Diabetes
Effect of InterferonBMI at the Initiation of Follow-UpBMI at the Onset of Diabetes
  1. Abbreviations: BMI, body mass index; SVR, sustained virological response.

SVR (n = 20)23.4 ± 2.524.5 ± 2.8
Non-SVR (n = 80)23.2 ± 2.623.4 ± 2.7

Yasuji Arase M.D.*, * Department of Hepatology, Toranomon Hospital, Tokyo, Japan.