title: Interferon therapy in hepatitis C leading to chronic type 1 diabetes.
abstract: OBJECTIVE
  To review the prevalence, clinical data and course of interferon- associated type 1 diabetes in chronic hepatitis C virus (HCV) infection.
  
  
  METHODS
  Search of all interferon (INF)-related type 1 diabetes mellitus (T1DM) cases published in the English literature from 1992 to December 2013 according to the key words: chronic hepatitis C infection, diabetes mellitus type 1, insulin dependent diabetes mellitus, and interferon treatment. We found 107 cases and analyzed their clinical and laboratory data and long-term follow-up. Due to the predominance of cases described in Japanese literature, we analyzed separately cases of Caucasian and Japanese origin. In addition we describe a representative case with HCV who developed INF-related T1DM.
  
  
  RESULTS
  Our data show that INF treatment increases the risk of developing T1DM by 10-18 fold compared with the corresponding general population and the median age of onset was 43 years (range: 24-66 years) in Caucasians and 52 years (range: 45-63 years) in Japanese. Most patients developed T1DM during INF treatment, after a median time-period of 4.2 and 5.7 mo in Caucasian and Japanese groups, respectively. The clinical course was characterized by a fulminant course with abrupt severe hyperglycemia or ketoacidosis, a high titer of anti-islet autoantibodies and almost all patients (105/107) permanently required insulin therapy with a follow-up of up to 4 years. A substantial number of patients had evidence for other autoimmune disorders mainly thyroid diseases (25% and 31% in Caucasian and Japanese groups, respectively).
  
  
  CONCLUSIONS
  INF-associated T1DM in HCV has a fulminant course, often associated with other autoimmune diseases, and results almost inevitably in permanent insulin therapy requirement.
authors.affiliation: Taiba Zornitzki, Lyudmila Lysyy, Hilla Knobler, Department of Diabetes, Metabolism and Endocrinology, Hebrew University Medical School, Kaplan Medical Center, Rehovot 76100, Israel.
authors.forename: Taiba
authors.initials: T
authors.lastname: Zornitzki
authors.affiliation: Taiba Zornitzki, Lyudmila Lysyy, Hilla Knobler, Department of Diabetes, Metabolism and Endocrinology, Hebrew University Medical School, Kaplan Medical Center, Rehovot 76100, Israel.
authors.forename: Stephen
authors.initials: S
authors.lastname: Malnick
authors.affiliation: Taiba Zornitzki, Lyudmila Lysyy, Hilla Knobler, Department of Diabetes, Metabolism and Endocrinology, Hebrew University Medical School, Kaplan Medical Center, Rehovot 76100, Israel.
authors.forename: Lyudmila
authors.initials: L
authors.lastname: Lysyy
authors.affiliation: Taiba Zornitzki, Lyudmila Lysyy, Hilla Knobler, Department of Diabetes, Metabolism and Endocrinology, Hebrew University Medical School, Kaplan Medical Center, Rehovot 76100, Israel.
authors.forename: Hilla
authors.initials: H
authors.lastname: Knobler
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D000998:Antiviral Agents / Q000009:adverse effects*; D044466:Asian People; D001323:Autoantibodies / Q000276:immunology; D015551:Autoimmunity; D003922:Diabetes Mellitus, Type 1 / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000208:ethnology / Q000276:immunology; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000188:drug therapy* / Q000208:ethnology / Q000276:immunology; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D007372:Interferons / Q000009:adverse effects*; D008875:Middle Aged; D010179:Pancreas / Q000276:immunology; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors; D044465:White People; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D001323:Autoantibodies; D007004:Hypoglycemic Agents; D007328:Insulin; D007372:Interferons
keywords: Autoimmune diseases; Hepatitis C; Interferon; Pancreatic autoantibodies; Type 1 diabetes