Peginterferon (PEG-IFN) Plus Ribavirin Combination Therapy, but neither Interferon nor PGE-IFN Alone, Induced Type 1 Diabetes in a Patient with Chronic Hepatitis C

Ogihara, Takehide; Katagiri, Hideki; Yamada, Tetsuya; Kudo, Hirohito; Imai, Junta; Ishigaki, Yasushi; Hinokio, Yoshinori; Yamagiwa, Yoko; Ueno, Yoshiyuki; Shimosegawa, Tooru; Oka, Yoshitomo

doi:10.2169/internalmedicine.48.2220

Cited by 10 publications

(6 citation statements)

References 22 publications

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“…3,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] We reviewed the data for each of these cases, focusing on the length of time from the start of IFN+RBV therapy to the onset of type 1 diabetes mellitus, continuation/discontinuation of IFN therapy after the onset of type 1 diabetes, weaning/nonweaning from insulin therapy after discontinuation of IFN+RBV, presence/ absence of pancreas-associated auto antibodies before and after IFN+RBV therapy, and the HLA haplotype of the patients ( Table 1). While in most cases IFN+RBV therapy had been discontinued immediately after the diagnosis of type 1 diabetes, 3,[8][9][10][11][12][13][14][15][16]18,[20][21][22][23][24] the treatment had been continued in two cases, including the present case. 25 Insulin therapy could be discontinued later in only two of the 19 cases in which IFN+RBV therapy had been stopped immediately after the diagnosis of type 1 diabetes.…”

Section: Discussionmentioning

confidence: 99%

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: 99%

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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“…Although Ogihara et al . reported that adding ribavirin on IFN therapy could be a trigger for type 1 diabetes, 11 the potency of IFN per se to impair β‐cell function should be kept in mind especially for the treatment of aged CHC patients using a small dose of PEG‐IFN for a prolonged period.…”

Section: Discussionmentioning

confidence: 99%

Classification and characteristics of interferon‐related diabetes mellitus in Japan

Muraishi

Sasaki

Kato

et al. 2011

Hepatology Research

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“…RBV also has immunomodulatory effects, but RBV is rarely used as monotherapy. However, there is a case report describing a patient who developed T1D after RBV was added to Peg-IFN ( 126 ).…”

Section: Pancreatic Islets Autoimmunity – Type 1 Diabetes and Hepatitmentioning

confidence: 99%

Diabetes and Hepatitis C: A Two-Way Association

et al. 2015

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Diabetes and hepatitis C infection are both prevalent diseases worldwide, and are associated with increased morbidity and mortality. Most studies, but not all, have shown that patients with chronic hepatitis C are more prone to develop type 2 diabetes (T2D) compared to healthy controls, as well as when compared to patients with other liver diseases, including hepatitis B. Furthermore, epidemiological studies have revealed that patients with T2D may also be at higher risk for worse outcomes of their hepatitis C infection, including reduced rate of sustained virological response, progression to fibrosis and cirrhosis, and higher risk for development of hepatocellular carcinoma. Moreover, hepatitis C infection and mainly its treatment, interferon α, can trigger the development of type 1 diabetes. In this review, we discuss the existing data on this two-way association between diabetes and hepatitis C infection with emphasis on possible mechanisms. It remains to be determined whether the new curative therapies for chronic hepatitis C will improve outcomes in diabetic hepatitis C patients, and conversely whether treatment with Metformin will reduce complications from hepatitis C virus infection. We propose an algorithm for diabetes screening and follow-up in hepatitis C patients.

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Peginterferon (PEG-IFN) Plus Ribavirin Combination Therapy, but neither Interferon nor PGE-IFN Alone, Induced Type 1 Diabetes in a Patient with Chronic Hepatitis C

Abstract: Interferon (IFN) therapies, including IFN, peginterferon (PEG-IFN)

Cited by 10 publications

References 22 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

Classification and characteristics of interferon‐related diabetes mellitus in Japan

Diabetes and Hepatitis C: A Two-Way Association

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