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Type 1 diabetes mellitus in patients with chronic hepatitis C before and after interferon therapy
Author(s) -
Fabris P.,
Floreani A.,
Tositti G.,
Vergani D.,
De Lalla F.,
Betterle C.
Publication year - 2003
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2003.01681.x
Subject(s) - medicine , diabetes mellitus , autoantibody , autoimmunity , immunology , type 1 diabetes , type 2 diabetes mellitus , alpha interferon , hepatitis c , interferon , population , interferon alfa , gastroenterology , endocrinology , immune system , antibody , environmental health
Summary Type 1 diabetes mellitus is the result of an autoimmune process characterized by pancreatic beta cell destruction. It has been reported that chronic hepatitis C infection is associated with type 2 diabetes mellitus, but not with type 1. Although the prevalence of markers of pancreatic autoimmunity in hepatitis C virus‐positive patients is not significantly different to that reported in the general population, it increases during alpha‐interferon therapy from 3 to 7%, probably due to the immunostimulatory effects of this cytokine. To date, 31 case reports of type 1 diabetes mellitus related to interferon treatment have been published. Type 1 diabetes mellitus occurs more frequently in patients treated for chronic hepatitis C than for other conditions and is irreversible in most cases. In 50% of these patients, markers of pancreatic autoimmunity predated treatment, the majority of cases having a genetic predisposition. Thus, in predisposed individuals, alpha‐interferon can either induce or accelerate a diabetogenic process already underway. We suggest that islet cell autoantibodies and glutamic acid decarboxylase autoantibodies should be investigated before and during interferon treatment in order to identify subjects at high risk of developing type 1 diabetes mellitus.