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Clinical Aspects of Chronic Hepatitis C Infection
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To the Editor: Dr Flamm1 did not discuss the association between chronic HCV infection and diabetes mellitus, nor its mechanism. Several studies from different parts of the world have found that 13% to 33% of patients with chronic HCV infection have associated diabetes, mostly type 2 diabetes.2-3 The increased prevalence of diabetes in patients with HCV without cirrhosis or other confounding factors3 is important as cirrhosis is commonly associated with impaired glucose tolerance, regardless of etiology. Thus, diabetes appears to be a unique extrahepatic manifestation of chronic HCV infection. The National Health and Nutrition Examination Survey III study4 has estimated an adjusted odds ratio of 3.37 of diabetes in patients older than 40 years with chronic HCV infection.
The mechanism of this association remains poorly understood. However, interferon treatment does not seem to be a major factor,5 whereas age older than 40 years, increased body mass index, family history of . . . [Full Text of this Article]
Ami Schattner, MD;
Hilla Knobler, MD
Department of Medicine
Hebrew University-Hadassah Medical School
Jerusalem, Israel
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