Chronic hepatitis C virus (HCV) infection is associated with an increased risk for type 2 diabetes (T2D), but the risk is significantly lower with the use of interferon (IFN)-based therapy, according to study results published in Diabetes Care.

Previous studies have shown that HCV is associated with increased insulin resistance secondary to the viral infection or the treatment. While IFN-based therapy is known to trigger short-term insulin resistance, limited data are available on the associated long-term risk of developing T2D. Furthermore, it is possible that viral clearance after treatment may reduce the risk for T2D.

The goal of the current study was to assess the risk for T2D among patients with chronic HCV infection and the effect of IFN-based therapy on that risk.

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The researchers identified 9094 patients (mean age, 55.5 years) with a new diagnosis of HCV infection who received IFN-based therapy between January 2000 and December 2011. They also randomly selected patients with chronic HCV who did not receive IFN-based therapy, matched for age and sex, and 36,376 individuals without HCV who served as the control group, also matched for age and sex.

The Kaplan-Meier method was used to estimate the cumulative incidence of T2D by the end of 2013, which was highest in the group of patients with chronic HCV who did not receive IFN-based therapy, followed by the control cohort and the group of patients with chronic HCV who did receive IFN-based therapy (17.7%, 14.9%, and 11.1%, respectively). The T2D incidence was 2.4-fold higher among those with chronic HCV who did not receive IFN-based therapy compared with those who did (1.72 vs. 0.73 per 100 person-years).

Compared with control individuals without HCV, the adjusted hazard ratios for T2D were 1.34 (95% CI, 1.24-1.46; P <.001) in patients with HCV not treated with IFN-based therapy and 0.65 (95% CI, 0.51-0.81; P <.001) in those with HCV treated with IFN-based therapy.

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The study had several limitations, including the use of clinician-initiated diagnoses and missing data on lifestyle, body mass index, and laboratory tests.

“Our study confirmed that [chronic HCV] patients without [IFN-based therapy] were at an elevated risk of T2D compared with non-[chronic HCV] control subjects. The risk was substantially reduced for [patients with HCV who received IFN-based treatment],” concluded the researchers.

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Tsai MC, Kao KL, Huang HC, et al. Incidence of type 2 diabetes in patients with chronic hepatitis C receiving interferon-based therapy [published online March 24, 2020]. Diabetes Care. doi:10.2337/dc19-1704