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SVR associated with lower risk for diabetes in HCV

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ORLANDO, Fla. — Patients with hepatitis C who achieve a sustained virologic response after treatment have a lower risk of developing type 2 diabetes, according to research presented here at Digestive Disease Week.

“There are intrahepatic factors and extrahepatic factors that link diabetes and HCV,” Sarah Hyder, MD, a gastroenterology fellow at Brown University, told Infectious Disease News. “Considering this link, we postulated that successful treatment of HCV could decrease the risk for new-onset diabetes in these patients.”

Hyder and colleagues used data from the Veterans Affairs Clinical Case Registry to identify patients with HCV, without pre-existing diabetes, who initiated antiviral treatment between 1998 and 2007. They evaluated the incidence of diabetes among patients who achieved sustained virologic response (SVR) and those who did not clear the infection.

Among the 27,636 patients, 7,617 (27.5%) achieved SVR and 15,243 (55.8%) did not. After a median follow-up of 5 years, 831 of the responders (11%) developed diabetes, and 2,428 of the non-responders (16%) developed diabetes. After controlling for known diabetes risk factors, SVR was independently associated with decreased incidence of new-onset diabetes (HR=0.77; 95% CI, 0.71-0.84). In addition, increasing age, non-white race, hypertension and cirrhosis were associated with an increased risk for new-onset diabetes.

“There are a lot of patients who don’t achieve SVR, either because they can’t tolerate treatment and discontinue, or because they have a resistant genotype of HCV,” Hyder said. “Hopefully, in the era of non-interferon based regimens, patients will be able to tolerate therapy better, and we’ll hopefully see an increased clearance rate and a decreased risk for HCV-associated diabetes. Successful treatment of HCV will provide significant benefits to health outcomes beyond liver-related morbidity and mortality.”

For more information:

Hyder S. #608. Presented at: Digestive Disease Week; May 18-21, 2013; Orlando, Fla.

Disclosure: Hyder reports no relevant financial disclosures.