Sobia S. Ali, Irum Sabir Ali, A H Aamir, Zahid Jadoon, Saima Inayatullah


Background: Diabetic patients are at an increased risk of acquiring Hepatitis C virus (HCV)
infection owing to the nature of the disease and its inherent complications or frequent parentral
exposure. On the other hand HCV infection may itself contribute to the development of Diabetes
Mellitus. The epidemiological evidence of this association has not been studied in Pakistan at a
population level and its exact biological mechanisms are not obvious. Objective of this study was
to study the frequency of HCV infection among adult diabetic patients attending the Hospital.
Methods : The study comprised of 100 Diabetic patients visiting the out patient clinics or admitted
in the medical wards of a Teaching Hospital, in Peshawar. Diabetes was confirmed according to
the new diagnostic criteria based on 2 fasting or 2 random plasma glucose levels of more than 126
milligram per deciliter (mg/dL) and 200 mg/dL respectively. The presence of HCV infection was
confirmed by Enzyme Linked Immuno-Sorbent Assay (ELISA) method. A concise history of the
patient, examination and laboratory findings were recorded on a Performa. Results: Out of the
hundred diabetics, 36% were found to be anti HCV positive and all of them had type II diabetes.
There was no gender difference in the seropositive cases. Serum Glutamic -Pyruvic Transaminase
(SGPT) level was raised in 75% of the positive cases as compared to the 25% of the seronegative
patients. The seropositive cases had a comparatively higher blood sugar level. Conclusion: HCV
infection occurs more often in type II diabetics and further investigations should be done in
diabetic patients with raised SGPT for the presence of chronic HCV infection.
Keywords : Hepatitis C virus, Diabetes mellitus.


Purcell RH. Hepatitis C virus; An Introduction. In: NIH

Consensus Development Conference on Management of

Hepatitis C.

Sene D, Limal N, Cacoub P. Hepatitis C virus - associated

extrahepatic manifest ations. a review. Metab Brain Dis


Mason A. Viral induction of type 2 diabetes and autoimmune

liver disease. J Nutr. 2001; 131 (10): 2805S-2808S.

www.who/int (Fact Sheet No.164, revised Oct . 2000.)

www.who/int (Press release WHO/36, 1st May 1998).

Simo R, Hernandez C, Genesca J, Jardi R, Mesa J. High

prevalence of hepatitis C virus infection in diabetic patients.

Diabetes Care. 1996;19(9):998-1000.

Chen LK, Hwang SJ, Tsai ST, Luo JC, Lee SD, Chang FY.

Glucose intolerance in Chinese patients with chronic hepatitis

C. World J Gastroenterol. 2003; 9(3):505-8.

Shlimovich PB, Zus’ BA, Evdokimov AR. Clinical picture

and pathogenesis of Diabetes Mellitus in Chronic Hepatitis

and Cirrhosis of the liver. Probl Endokrinol (Mosk)


Fraser GM, Harman I, Meller N, Niv Y, Porath A. Diabetes

mellitus is associated with chronic hepatitis C but not chronic

hepatitis B infection. Isr J Med Sci. 1996;32(7):526-30.

Ryu JK , Lee SB , Hong SJ , Lee S. Association of chronic

hepatitis C virus infection and diabetes mellitus in Korean

patients. Korean J Intern Med. 2001;16(1):18-23.

Younas BB, Khan GM, Chaudhary MA. Prevalence of

diabetes mellitus among patients suffering from chronic liver

disease. Mother and Child 2000; 38 (1): 37-40.

Shah IA, Shah SWA, Hayat Z, Haq NU, Noor M, ArshadM.

Impaired glucose tolerance in HCV/HBV cirrhosis. J

Postgrad Med Inst ; 14(1):68-72.

Mehta SH, Brancati FL, Sulkowski MS, Strathdee SA, Szklo

M, Thomas DL. Prevalence of type 2 diabetes mellitus

among persons with hepatitis C virus infection in the United

States. Ann Intern Med. 2000; 133(8): 592-9.

Gray H, Wreghitt T, Stratton IM, Alexander GJ, Turner RC,

O’Rahilly S . High prevalence of hepatitis C infection in

Afro-Carribean patients with type 2 diabetes and abnormal

liver function tests. Diabet Med. 1995; 12(3): 244-9.

Caronia S, Taylor K, Pagliaro L, Carr C, Palazzo U, Petrik J

et al. Further evidence for an association between noninsulin-dependant diabetes mellitus and chronic hepatitis C

virus infection. Hepatology 1999;30(4):1059- 63.

Everhart J. A confluence of epidemics: does hepatitis C cause

type 2 Diabetes? Hepatology. 2001; 33(3): 762-3.

Chen LK, Chou YC, Tsai ST, Hwang SJ, Lee SD. Hepatitis

C virus infection-related Type 1 diabetes mellitus.

Diabet Med. 2005; 22(3);:340-43.

Mason AL, Lau JY, Hoang N, Qian K, Alexander GJ, Xu L

et al. Association of diabetes mellitus and chronic hepatitis C

virus infection. Hepatology. 1999;29(2): 328-33.

Cacoub P, Poynard T, Ghillani P, Charlotte F, Olivi M, Piette

JC et al. Extra hepatic manifestations of chronic hepatitis C.

MULTIVIRC Group. Multidepartment Virus C. Arthritis

Rheum. 1999; 42(10): 2204-12.

Hadziyannis SJ. Diabetes Mellitus and Chronic hepatitis C

virus infection. Hepatology, 1999; 29:604-605.

Lin SC, Shih SC, Kao CR, Chou SY. Prevalence of

antibodies to hepatitis C virus in patients with non-alcoholic

fatty liver. Zhonghua Yi Xue Za Zhi (Taipei). 1995; 56(2):


Visnegarwala F, Chen L, Raghavan S, Tedaldi E. P revalence

of diabetes mellitus and dyslipidemia among antiretroviral

naive patients co-infected with hepatitis C virus(HCV) and

HIV-1 compared to patients without co-infection1. J infect .


Zein CO, Levy C, Basu A, Zein NN. Chronic hepatitis C and

type II diabetes mellitus: a prospective cross sectional st udy.

Am J Gastroenterol. 2005;100(1): 48-55.

Lecube A, Hernandez C, Genesca J , Esteban JI, Jardi R,

Simo R. High prevalence of glucose abnormalities in patients

with hepatitis C virus infection: a multivariate analysis

considering the liver injury. Diabetes Care 2004;27(5):1171-


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