Effect of sustained virological response to treatment on the incidence of abnormal glucose values in chronic hepatitis C.
OBJECTIVE
To investigate the effect of sustained virological response (SVR) on impaired fasting glucose (IFG) and/or type 2 diabetes (T2DM); to assess the influence of glucose abnormalities on the SVR rate.


METHODS
1059 patients with chronic HCV; normal glucose (< 100 mg/dl) in 734, IFG (between 100 and 125 mg/dl) in 218, and T2DM (126 mg/dl) in 107 cases, were treated with interferon plus ribavirin over 24 or 48 weeks, depending on viral genotype.


RESULTS
The SVR rate was lower in patients with IFG and/or T2DM than in patients with normal glucose concentrations [143/325 (44%) vs. 432/734 (58.8%); P=0.002]. In the follow-up, abnormal glucose concentrations were observed in 74 of 304 (24.3%) non-responders and in 49 of 430 (11.4%) sustained responders (log-rank: 13.8; P=0.00002). Reverse stepwise logistic regression analysis identified the independent variables predictive of IFG or T2DM development as: sustained response (OR: 0.44; 95%CI=0.20-0.97; P=0.004) and fibrosis stage (OR: 1.46; 95%CI=1.06-2.01;P=0.02). Family history of DM, steatosis, gender, HCV viral load, genotype, triglycerides, cholesterol and BMI did not enter the multivariate analysis equation.


CONCLUSIONS
SVR reduces the risk of IFG and/or T2DM development in patients with chronic hepatitis C while altered glucose metabolism impairs sustained response to viral treatment.
Romero-Gómez
Manuel
M
Unit for the Clinical Management of Digestive Diseases and CIBEREHD, Hospital Universitario de Valme, Seville, Spain. mromerog@supercable.es
Fernández-Rodríguez
Conrado M
CM
Andrade
Raúl J
RJ
Diago
Moisés
M
Alonso
Sonia
S
Planas
Ramón
R
Solá
Ricard
R
Pons
José A
JA
Salmerón
Javier
J
Barcena
Rafael
R
Perez
Ramón
R
Carmona
Isabel
I
Durán
Santiago
S
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001786:Blood Glucose / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology*; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000097:blood / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007372:Interferons / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D012254:Ribavirin / Q000008:administration & dosage; D019562:Viral Load
D001786:Blood Glucose; D012254:Ribavirin; D007372:Interferons; D000410:Alanine Transaminase