Impact of sustained virological response on incidence of type 2 diabetes in hepatitis c patients.

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Background and Aims: Data regarding the impact of treatment for hepatitis C virus (HCV) on incidence of type 2 diabetes mellitus (T2D) are limited by small sample sizes, patients in clinical trials, or non‐US populations. The longitudinal Chronic Hepatitis Cohort Study (CHeCS)—a geographically and racially‐diverse cohort of chronically infected HCV patients from four large US health systems— offers a unique opportunity to assess how sustained virological response (SVR) to HCV treatment interacts with known risk factors to influence development of T2D. Methods: Treated HCV patients without prior history of T2D or hepatitis B were included. Baseline risk factors included age, gender, race, HCV treatment outcome, viral genotype, and Fibrosis‐4 (FIB4). Incidence of T2D was observed from the date of either SVR or 12 weeks’ after end of treatment failure (TF), through patients’ last encounter prior to 12/31/2015. The Cox proportional hazards model was used to test the effect of SVR and other baseline risk factors on development of T2D, considering any possible risk factor‐by‐SVR interactions and death as a competing risk. Results: Among 4731 patients with median of 3 years’ of follow‐up, 176 of 2971 (5.92%) SVR patients and 330 of 1760 (18.72%) TF patients developed T2D (Hazard Ratio [HR]=0.72; 95%CI [0.60‐0.87]). The effect of treatment was consistent across baseline risk factors. Risk of T2D was higher among African American and Asian American patients than white patients (HR=1. 9 and 1. 5, respectively; p<0.05), regardless of BMI. Genotype 1 or 4 were not risks for T2D. Conclusions: In patients with chronic HCV, successful treatment significantly reduces the incidence of T2D. The effect is consistent regardless of baseline risk factors.




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