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Review
. 2015 Jan 7;21(1):233-9.
doi: 10.3748/wjg.v21.i1.233.

Interferon therapy in hepatitis C leading to chronic type 1 diabetes

Taiba Zornitzki  1 , Stephen Malnick  1 , Lyudmila Lysyy  1 , Hilla Knobler  1
Affiliations
Review

Interferon therapy in hepatitis C leading to chronic type 1 diabetes

Taiba Zornitzki et al. World J Gastroenterol. .

Abstract

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.

Keywords: Autoimmune diseases; Hepatitis C; Interferon; Pancreatic autoantibodies; Type 1 diabetes.

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