Interferon therapy in hepatitis C leading to chronic type 1 diabetes
| Autor: | Hilla Knobler, Stephen Malnick, Lyudmila Lysyy, Taiba Zornitzki |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Adult
medicine.medical_specialty Time Factors endocrine system diseases Fulminant medicine.medical_treatment Population Autoimmunity Antiviral Agents White People Young Adult Asian People Retrospective Study Risk Factors Internal medicine Diabetes mellitus medicine Prevalence Humans Hypoglycemic Agents Insulin Age of Onset education Pancreas Aged Autoantibodies Type 1 diabetes education.field_of_study business.industry Gastroenterology General Medicine Hepatitis C Hepatitis C Chronic Middle Aged medicine.disease Prognosis Ketoacidosis Diabetes Mellitus Type 1 Immunology Interferons Age of onset business |
| Popis: | AIM: To review the prevalence, clinical data and course of interferon- associated type 1 diabetes in chronic hepatitis C virus (HCV) infection. METHODS: Search of all interferon (INF)-related type 1 diabetes mellitus (T1DM) cases published in the English literature from 1992 to December 2013 according to the key words: chronic hepatitis C infection, diabetes mellitus type 1, insulin dependent diabetes mellitus, and interferon treatment. We found 107 cases and analyzed their clinical and laboratory data and long-term follow-up. Due to the predominance of cases described in Japanese literature, we analyzed separately cases of Caucasian and Japanese origin. In addition we describe a representative case with HCV who developed INF-related T1DM. RESULTS: Our data show that INF treatment increases the risk of developing T1DM by 10-18 fold compared with the corresponding general population and the median age of onset was 43 years (range: 24-66 years) in Caucasians and 52 years (range: 45-63 years) in Japanese. Most patients developed T1DM during INF treatment, after a median time-period of 4.2 and 5.7 mo in Caucasian and Japanese groups, respectively. The clinical course was characterized by a fulminant course with abrupt severe hyperglycemia or ketoacidosis, a high titer of anti-islet autoantibodies and almost all patients (105/107) permanently required insulin therapy with a follow-up of up to 4 years. A substantial number of patients had evidence for other autoimmune disorders mainly thyroid diseases (25% and 31% in Caucasian and Japanese groups, respectively). CONCLUSION: INF-associated T1DM in HCV has a fulminant course, often associated with other autoimmune diseases, and results almost inevitably in permanent insulin therapy requirement. |
| Databáze: | OpenAIRE |
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