Original Contribution Hepatitis C Virus Infection and the Development of Type 2 Diabetes in a Community-based Longitudinal Study

The temporal relation of hepatitis C virus (HCV) infection to the development of type 2 diabetes remains unknown. Theauthors followed4,958 persons aged40 yearswithout diabetes (3,486 seronegative, 812anti-HCVþ, 116with hepatitis B virus/HCV coinfection, and 544 hepatitis B surface antigen (HBsAg)þ) from a community-wide cohort in southern Taiwan for 7 years (1997–2003) to study the risk of diabetes associated with HCV infection. A total of 474 participants developed diabetes. The 7-year cumulative incidence was 7.5 % for HBsAgþ, 8.6 % for seronegative, 14.3 % for anti-HCVþ, and 14.7 % for coinfected participants. Compared with HCV persons, HCVþ persons had a higher cumulative incidence of diabetes (log-rank test, p< 0.0001). Amultivariate Cox proportional hazardsmodel showed that anti-HCVþ (hazard ratio 1.7, 95 % confidence interval: 1.3, 2.1), coinfection (hazard ratio 1.7), overweight, obesity, and increasing age were significantly associated with diabetes (p< 0.05). Gender, educational level, HBsAgþ status, alcohol consumption, and smoking were not significant. After stratification by age and body mass index, the risk ratio for diabetes in anti-HCVþ participants increased when age decreased and body mass index levels increased (p < 0.001). Results show that HCV infection is an independent predictor of diabetes, especially for anti-HCVþ persons who are younger or have a higher body mass index. body mass index; cohort studies; diabetes mellitus; hepatitis C Abbreviations: HBsAg, hepatitis B surface antigen; HBV, hepatitis B virus; HCV, hepatitis C virus