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Hepatitis C virus infection and development of type 2 diabetes mellitus: Systematic review and meta-analysis of the literature

  • Silvia Fabiani
  • Poupak Fallahi
  • Silvia Martina Ferrari
  • Mario Miccoli
  • Alessandro Antonelli
Article

Abstract

Type 2 diabetes mellitus (T2DM) is an endocrine disorder encompassing multifactorial mechanisms, and chronic hepatitis C virus infection (CHC) is a multifaceted disorder, associated with extrahepatic manifestations, including endocrinological disorders. CHC and T2DM are associated, but the subject remains controversial. We performed a systematic review and meta-analysis evaluating such association, searching on PubMed until February 29, 2016. Inclusion criteria were: 1) presence of at least one internal control group age- and gender-matched (non-hepatopathic controls; and/or hepatopathic, not HCV-positive, controls); 2) sufficient data to calculate odds ratio and relative risk. Exclusion criteria were: 1) literature reviews on the topic; 2) publications regarding special populations [human immunodeficiency virus and human T-lymphotropic virus-1 coinfections, hepatocellular carcinoma (HCC), post-transplantation DM, gender selection]; 3) no clear differentiation among HCV patients with CHC, cirrhosis or HCC. Data from each study were independently extracted by two reviewers and cross-checked by AA. Our systematic review returned 544 records, and 33 were included in our meta-analysis. HCV infection is associated with an increased risk of T2DM independently from the severity of the associated liver disease, in CHC and cirrhotic HCV patients. As expected T2DM risk is higher in cirrhotic HCV patients, than CHC, and the prevalence of HCV infection in T2DM patients is higher than in non-diabetic controls. Regarding HBV infection prevalence, no difference exists in diabetic and non-diabetic subjects. An unequivocal CHC and T2DM association was shown. A proactive, integrated approach to HCV and T2DM therapies should maximize benefits of both diseases treatment.

Keywords

Hepatitis C virus Hepatitis C extra-hepatic manifestations Hepatitis B virus Type 2 diabetes mellitus Meta-analysis 

Abbreviations

CH

Chronic hepatitis

CHC

Chronic hepatitis C virus infection

DAA

Direct-acting antiviral treatment

DM

Diabetes mellitus

EHM

Extra-hepatic manifestations

HCC

Hepatocellular carcinoma

HBV

Hepatitis B virus

HCV

Hepatitis C virus

HIV

Human immunodeficiency virus

HTLV

Human T-lymphotropic virus

IR

Insulin resistance

NIDDM

Non-insulin dependent diabetes

OR

Odds ratio

PTDM

Post transplantation diabetes mellitus

RR

Relative risk

SVR

Sustained virological response

T2DM

Type 2 diabetes mellitus

Notes

Funding

The authors have nothing to declare.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Silvia Fabiani
    • 1
  • Poupak Fallahi
    • 1
  • Silvia Martina Ferrari
    • 1
  • Mario Miccoli
    • 1
  • Alessandro Antonelli
    • 1
  1. 1.Department of Clinical and Experimental Medicine, School of MedicineUniversity of PisaPisaItaly

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