Hepatitis C virus infection‐related Type 1 diabetes mellitus

Chen, L. K.; Chou, Yueh Ching; Tsai, Shih-Tzer; Hwang, Shinn Jang; Lee, S. D.

doi:10.1111/j.1464-5491.2005.01412.x

Cited by 40 publications

(21 citation statements)

References 35 publications

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“…According to a report by Mehta et al, the incidence of type 2 diabetes mellitus is about three times higher in HCV-infected individuals than in noninfected individuals overthe age of 40 years 6. In contrast it has also been reported that the incidence of type 1 diabetes mellitus as a complication is lower than that of type 2 diabetes mellitus 7. It has also been reported that the pancreas-associated autoantibody (including antiglutamic acid decarboxylase antibody) positivity rate in HCV patients is 3% before the start of IFN therapy but increases to 7% thereafter 1.…”

Section: Discussionmentioning

confidence: 98%

Type 1 Diabetes Mellitus Associated with Pegylated Interferon-α Plus Ribavirin Treatment for Chronic Hepatitis C: Case Report and Literature Review

Oka

Hiroi

Shigemitsu

et al. 2011

Clin Med Insights Endocrinol Diabetes

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Combined pegylated interferon (PEG-IFN)+ribavirin (RBV) therapy has been used as a primary treatment for chronic hepatitis C. However, IFN-induced autoimmune disease, including type 1 diabetes mellitus, has been highlighted as one of the problems with this therapy. Here we report the case of a patient who developed type 1 diabetes mellitus during combined PEG-IFN+RBV therapy for hepatitis C but who showed no exacerbation of diabetes despite continued use of IFN. A 63-year-old man with chronic hepatitis C and a nonresponder to previous IFNα treatments, was admitted to our hospital because of excessive thirst, polydipsia, and polyuria 24 weeks after the start of PEG-IFNα+RBV therapy. High levels of blood glucose and glycosylated hemoglobin and low levels of C-peptide and immunoreactive insulin were observed. The serum antiglutamic acid decarboxylase antibody titer was 27,700 U/mL. We diagnosed IFN-induced type 1 diabetes mellitus; however PEG-IFNα+RBV therapy was continued for 48 weeks. Serum HCV remains negative five years after this treatment. Intensive insulin therapy was started immediately after the diagnosis of type 1 diabetes. Although the patient initially required 22 U/day of insulin, the dosage could be gradually reduced after completion of PEG-IFNα+RBV therapy and blood glucose remained well controlled. Prediction of onset of type 1 diabetes mellitus on the basis of baseline measurement of pancreas-associated autoantibodies is difficult. Therefore, it would be advisable to consider the possibility of onset of type 1 diabetes mellitus in all patients receiving IFN+RBV therapy.

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Section: Discussionmentioning

confidence: 98%

Type 1 Diabetes Mellitus Associated with Pegylated Interferon-α Plus Ribavirin Treatment for Chronic Hepatitis C: Case Report and Literature Review

Oka

Hiroi

Shigemitsu

et al. 2011

Clin Med Insights Endocrinol Diabetes

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“…Gastrointestinal infections and in more extreme cases myocarditis (inflammation of the heart) and pericarditis (inflammation of the sack surrounding the heart) T1D [92][93][94][95] Hepatitis B Hepadnaviridae Liver inflammation SLE [96,97] Hepatitis C Hepadnaviridae Liver inflammation MG [98,99], GD [100,101], T1D [102,103], SLE [104]…”

Section: Coxsachie B Virus Picornaviridaementioning

confidence: 99%

The HLA Region and Autoimmune Disease: Associations and Mechanisms of Action

Gough

Simmonds²

2007

401

172

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Abstract:The HLA region encodes several molecules that play key roles in the immune system. Strong association between the HLA region and autoimmune disease (AID) has been established for over fifty years. Association of components of the HLA class II encoded HLA-DRB1-DQA1-DQB1 haplotype has been detected with several AIDs, including rheumatoid arthritis, type 1 diabetes and Graves' disease. Molecules encoded by this region play a key role in exogenous antigen presentation to CD4+ Th cells, indicating the importance of this pathway in AID initiation and progression. Although other components of the HLA class I and III regions have also been investigated for association with AID, apart from the association of HLA-B*27 with ankylosing spondylitis, it has been difficult to determine additional susceptibility loci independent of the strong linkage disequilibrium (LD) with the HLA class II genes. Recent advances in the statistical analysis of LD and the recruitment of large AID datasets have allowed investigation of the HLA class I and III regions to be re-visited. Association of the HLA class I region, independent of known HLA class II effects, has now been detected for several AIDs, including strong association of HLA-B with type 1 diabetes and HLA-C with multiple sclerosis and Graves' disease. These results provide further evidence of a possible role for bacterial or viral infection and CD8+ T cells in AID onset. The advances being made in determining the primary associations within the HLA region and AIDs will not only increase our understanding of the mechanisms behind disease pathogenesis but may also aid in the development of novel therapeutic targets in the future.

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“…Even rarer are reports on the potential association between autoimmune diabetes and acute HCV infection. Only two cases have been described in the literature [151,152] . Several mechanisms have been postulated to initiate the process.…”

Section: Hcv-infected Patients With T1dmmentioning

confidence: 99%

Hepatitis C virus infection and type 1 and type 2 diabetes mellitus

Antonelli

Ferrari

Giuggioli

et al. 2014

WJD

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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. AbstractHepatitis 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 Submit a

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Hepatitis C virus infection‐related Type 1 diabetes mellitus

Abstract: The simultaneous development of HCV infection and diabetes-related autoantibodies suggest a relationship between HCV and Type 1 DM.

Cited by 40 publications

References 35 publications

Type 1 Diabetes Mellitus Associated with Pegylated Interferon-α Plus Ribavirin Treatment for Chronic Hepatitis C: Case Report and Literature Review

Type 1 Diabetes Mellitus Associated with Pegylated Interferon-α Plus Ribavirin Treatment for Chronic Hepatitis C: Case Report and Literature Review

The HLA Region and Autoimmune Disease: Associations and Mechanisms of Action

Hepatitis C virus infection and type 1 and type 2 diabetes mellitus

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