Open AccessHepatitis C virus infection and type 1 and type 2 diabetes mellitus
Author(s) -
A Antonelli,
Silvano Ferrari,
Dilia Giuggioli,
Di Domenicantonio A,
Ilaria Ruffilli,
Alda Corrado,
Silvia Fabiani,
Santino Marchi,
Clodoveo Ferri,
Ele Ferrannini,
P Fallahi
Publication year - 2014
Publication title -
world journal of diabetes
Language(s) - English
Resource type - Journals
ISSN - 1948-9358
DOI - 10.4239/wjd.v5.i5.586
Subject(s) - medicine , diabetes mellitus , hepatocellular carcinoma , type 1 diabetes , cirrhosis , hepatitis c virus , immunology , hepatitis c , type 2 diabetes mellitus , autoimmunity , immune system , interferon , chemokine , type 2 diabetes , virus , endocrinology
Hepatitis C virus (HCV) infection and diabetes mellitus are two major public health problems that cause devastating health and financial burdens worldwide. Diabetes can be classified into two major types: type 1 diabetes mellitus (T1DM) and T2DM. T2DM is a common endocrine disorder that encompasses multifactorial mechanisms, and T1DM is an immunologically mediated disease. Many epidemiological studies have shown an association between T2DM and chronic hepatitis C (CHC) infection. The processes through which CHC is associated with T2DM seem to involve direct viral effects, insulin resistance, proinflammatory cytokines, chemokines, and other immune-mediated mechanisms. Few data have been reported on the association of CHC and T1DM and reports on the potential association between T1DM and acute HCV infection are even rarer. A small number of studies indicate that interferon-α therapy can stimulate pancreatic autoimmunity and in certain cases lead to the development of T1DM. Diabetes and CHC have important interactions. Diabetic CHC patients have an increased risk of developing cirrhosis and hepatocellular carcinoma compared with non-diabetic CHC subjects. However, clinical trials on HCV-positive patients have reported improvements in glucose metabolism after antiviral treatment. Further studies are needed to improve prevention policies and to foster adequate and cost-effective programmes for the surveillance and treatment of diabetic CHC patients.