Antiviral Therapy For Hep C Improved Diabetes Outcomes
Research from Taiwan has shown that antiviral therapy for hepatitis C virus improved kidney and cardiovascular outcomes for patients with diabetes.
AsianScientist (Dec. 16, 2013) - Research from Taiwan has shown that antiviral therapy for hepatitis C virus (HCV) improved kidney and cardiovascular outcomes for patients with diabetes.
Results of the study, published in the journal Hepatology, show that incidences of kidney disease, stroke, and heart attack were lower in patients treated with pegylated interferon and ribavirin compared to HCV patients not treated with antivirals or diabetic patients not infected with the virus.
The World Health Organization estimates that diabetes affects 347 million individuals worldwide and another 170 million people are living with chronic HCV. Previous research suggests a link between diabetes and chronic HCV, with HCV infected individuals having a greater chance of developing insulin resistance and diabetes.
Moreover, HCV patients with insulin resistance, with or without diabetes, have a poor response to antiviral treatment, increased progression of liver fibrosis and greater risk of developing liver cancer (hepatocellular carcinoma).
"There is growing evidence of an association between diabetes and HCV," said lead author, Chun-Ying Wu from Taichung Veterans General Hospital in Taiwan. "Our study investigates if antiviral therapy used to treat HCV infection also improves diabetes outcomes."
For this population-based study researchers used data from the Taiwan National Health Insurance Research Database, which has collected healthcare details for all residents of the country since 1997. The team identified 1,411 patients with diabetes and HCV who were enrolled in the study, and received pegylated interferon plus ribavirin. There were also 1,411 individuals in the untreated group and 5,644 patients with diabetes and without HCV in the uninfected cohort. Follow-up for all participants was from 2003 to 2011.
Findings indicate that the eight-year cumulative incidences of end-stage renal disease in the treated, untreated and uninfected groups were 1.1 percent, 9.3 percent, and 3.3 percent, respectively. Further analysis found stroke incidence was 3.1 percent for treated patients, 5.3 percent for untreated and 6.1 percent for uninfected subjects.
Acute coronary syndrome - an umbrella term the American Heart Association uses to define diseases, such as heart attack or angina, where blood to the heart is blocked - occurred in 4.1 percent, 6.6 percent and 7.4 percent of treated, untreated and uninfected patients.
"Our findings suggest that HCV may cause clinical complications related to diabetes. But these issues are mitigated by HCV antiviral therapy, specifically pegylated interferon plus ribavirin, which was found to reduce risks of kidney disease, stroke and cardiovascular diseases in diabetic patients," said Wu.
The authors recommend further examination of the underlying relationship between HCV and diabetes.
Source: Taichung Veterans General Hospital; Photo: AJC1/Flickr/CC.
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