Clinical

HCV treatment improves heart, renal outcomes in diabetics

Last Updated: 2014-01-01 10:50:35 -0500 (Reuters Health)

By Reuters Staff

NEW YORK (Reuters Health) - Diabetics with hepatitis C who receive antiviral treatment have better renal and cardiovascular outcomes than patients whose infections go untreated, new findings show.

Hepatitis C virus (HCV) infection is known to cause insulin resistance and diabetes, Dr. Yao-Chun Hsu of China Medical University in Taichung, Taiwan and colleagues note. Eradicating HCV infection can improve insulin resistance, they add, but it's not clear how treating HCV might affect outcomes in patients with diabetes.

To investigate, Dr. Hsu and colleagues looked at data on nearly 2.3 million diabetic patients in the Taiwan National Health Insurance Research Database, identifying 1,411 patients with HCV who were receiving pegylated interferon plus ribavirin. The investigators matched them with 1,411 untreated controls and 5,644 diabetic patients without HCV.

As reported online in Hepatology, the cumulative incidence of end-stage renal disease (ESRD) between 2003 and 2011 was 1.1% for the treated HCV patients, 9.3% for the untreated HCV patients, and 3.3% for the diabetic patients without HCV (p<0.001).

Stroke risk was 3.1% for treated patients, 5.3% for untreated patients, and 6.1% for HCV-free patients (p=0.01).

Acute coronary syndrome occurred in 4.1% of treated patients, 6.6% of untreated patients, and 7.4% of the patients without HCV (p=0.05).

The multivariate-adjusted hazard ratio associated with treatment was 0.16 for ESRD, 0.53 for ischemic stroke, and 0.64 for acute coronary syndrome.

"These findings suggest that HCV infection may have a role in the pathogenesis of renal and cardiovascular complications among diabetic patients, and also implicate that treatment of concomitant HCV infection may improve clinical outcomes related to DM," Dr. Hsu and colleagues write.

They add, "The efficacy of anti-HCV therapy in ameliorating insulin resistance and restoring glucose homeostasis, which has been convincingly demonstrated in previous studies, may underlie the associations uncovered in our research."

The authors did not respond to a request for comment.

SOURCE: http://bit.ly/1dPStc2

Hepatology 2013.