Type 2 diabetes mellitus and chronic hepatitis C: Which is worse? Results of a long-term retrospective cohort study.

Background: The long-term outcome in patients with chronic hepatitis C and type 2 diabetes mellitus treated with Interferon and Ribavirin is not clear. Aim: to compare the incidence of liver-related events and mortality rates between Hepatitis C Virus-positive patients with or without diabetes mellitus and the incidence of diabetes-related events between diabetic patients with and without viral infection. Methods: 309 patients with chronic hepatitis C were retrospectively included. Incidence of liver-related events, diabetes-related events and mortality rates were assessed. Results: 50 (16%) chronic hepatitis C patients had diabetes mellitus. Diabetics showed a higher number of diabetes mellitus- and liver-related events (10% vs 1.5% and 18% vs 5.7%) than non-diabetics (p=0.006, and p=0.007 respectively) with a mortality of 14% compared to 1.5% (p= 0.0003). Baseline cirrhosis (p=0.002) and non-sustained virological response ( p=0.01) were the only independent risk factors for liver events while diabetes mellitus (p=0.01) and hypertension (p=0.0017) were the only independent factors associated with diabetes-related events. Mortality and diabetes events were lower among Hepatitis C Virus-positive diabetics than among Hepatitis C Virus- negative diabetics (p=0.053, p<0.0001 respectively). Conclusions: in patients with chronic hepatitis C, diabetes mellitus was associated to a higher mortality rate and incidence of liver/diabetes-related events. However, only diabetes-related events were independently predicted by diabetes mellitus. When compared to Hepatitis C Virus-negative diabetics, those with chronic hepatitis C showed a lower mortality and a decreased incidence of diabetic complications.