Seroprevalence of hepatitis C in diabetic patients in an urban South African setting

Abstract

INTRODUCTION: Both hepatitis C virus (HCV) infection and diabetes mellitus (DM) are common illnesses with potentially devastating complications. There have been studies suggesting that HCV is a potential cause of diabetes by initially causing insulin resistance which then progresses to overt DM. STUDY DESIGN AND METHODS: Patients from the Diabetes Clinic at the Charlotte Maxeke Johannesburg Hospital were recruited to the study from January to November 2007. Both type 1 and type 2 diabetic patients were recruited and were compared to a group of first time, apparently healthy blood donors (data provided by the South African National Blood Services) for infection with HCV. Our patients were tested for HCV by the use of a rapid test device which detects the presence of HCV antibodies. Patients who were positive on antibody testing had a confirmatory PCR done. RESULTS: The prevalence of HCV infection was higher in our diabetic group than in the blood donors (1, 55% vs. 0, 02%; P=0, 0001; Odds ratio 69; 95%CI; 22-212). Furthermore, the prevalence was higher amongst type 2 than in the type 1 diabetic patients but this difference was not statistically significant (7/443(1, 58%) vs. 1/73(1, 37%) P= >0, 05). Five of the eight patients who had a positive antibody test were also positive on PCR testing, and this was still statistically significant (5/516 (0.97%) vs. 8/35194; P =0.005). Previous exposure to recognized risk factors for HCV infection did not appear to be related to acquiring HCV. CONCLUSIONS: There appears to be a higher prevalence of HCV among patients with diabetes than in those without. Whether HCV has a direct causative role or not remains to be proven but there seems to be a link.