Background: Hepatitis C virus infection seems to induce insulin resistance and type 2 diabetes by direct viral involvement. The prevalence of glucose metabolism disorders is higher in C virus infected non-cirrhotic patients in comparation with patients with other etiology liver diseases.
Material and method: Two-hundred seventy patients with chronic C hepatitis were compared to 163 patients with chronic B hepatitis, regarding glucose metabolism before and after antiviral therapy and regarding the risk factors of diabetes.
Results: The prevalence of insulin resistance was 19% in hepatitis C and 6.7% in hepatitis B patients (p<0.0001). 90.2% of insulin resistant patients with C hepatitis had viraemia ≥800,000UI/ml. After viral eradication plasma glucose and insulin levels decreased significantly (p<0.0001). In this group of patients, eradication was obtained less (66.7%) than in the non-insulin resistent C hepatitis (84.4%) or insulin resistant B hepatitis group (80.0%).
Conclusions: Hepatitis C virus infection increases the risk of diabetes compared with hepatitis B virus, irrespectively of classic diabetes risk factors, but dependent on viraemia. Insulin resistance decreases therapeutic response only in hepatitis C, but viral eradication improves glucose metabolism in these patients.