• Abate Bane Addis Ababa University, Medical faculty, Department of Internal Medicine, Addis Ababa, Ethiopia


Background. Chronic hepatitis C virus (HCV) is a pandemic affecting more than 170 million people worldwide. It leads to cirrhosis, hepatocellular carcinoma, and extra hepatic complications like type 2 Diabetes Mellitus (DM) in up to 13-33%.

Objective. To assess the association of chronic HCV with DM among adult Ethiopians.

Patients and Methods.This case control study was conducted at Adera Medical and Gastroenterology center in Addis Ababa during September 1 through November 30,2015. One hundred forty one cases and 359 controls were included in the study after consent. Data regarding DM risk factors,CBC, liver chemistry, FBS, andsonographywere collected. HCV screening was done by rapid antibody test and confirmed by ELISA followed by PCR genotype and viral load testing fortreatment. The data were analyzed using SPSS version 20 software including Odds ratio and 95% confidence interval.

Results. Among the 141 cases with HCV infection, most (69.5 %) were from Addis Ababa, 54% were females with mean age of 50 years.. Genotypes 4 and 1 were predominant in 70% and 20%, respectively. Type 2 DM was diagnosed among 31% and 27% of the males and females with HCV infection, respectively in contrast to 4.2 % and 2.8% among matching controls.

Conclusion. HCV infection is significantlyassociated with development of type 2 Diabetes Mellitus, as opposed to controls, indicating the importance of screening for DM and vice versa.

Key words: HCV, Diabetes Mellitus, Ethiopia


Palekar NA, Harrison SA. Extrahepatic manifestations of hepatitis C. South Med J 2005; 98:1019–23.

Fabrizi F, Lampertico P, Lunghi G, et al. Hepatitis C virus infection and type 2 diabetes mellitus in renal diseases and transplantation. Aliment PharmacolTher2005 ;21:623–32.

M. Stepanova, B. Lam, Y. Younossi, et al.Association of Hepatitis C with Insulin Resistance and Type 2 Diabetes in US General Population.J Viral Hepat. 2012; 19: 341-345.

Farrell FJ. Diabetes and the hepatobiliary system. Clin Liver Dis 1998; 2: 119–31.

Ozyilkan E, Erbas T, Simsek H et al. Increased prevalence of hepatitis C virus antibodies in patients with diabetes mellitus. J Intern Med 1994; 235:283–4.

Simo R, Jardi R, Hernandez C, et al. High prevalence of hepatitis C virus infection in diabetic patients. Diabetes Care 1996 ;19:998–1000.

Chen HF, Li CY, Chen P, et al. Seroprevalence of hepatitis B and C in type 2 diabetic patients. J Chin Med Assoc2006 ;69:146–52.

Li CP, Hwang SJ, Lu CL, et al. Risk factor analysis of patients with chronic hepatitis C in Taiwan. J Chin Med Assoc 1996;58:275–80.

Allison MED, Wreghitt T, Palmer CR. Evidence for a link between hepatitis C virus infection and diabetes mellitus in a cirrhotic population. J Hepatol 1994; 21: 1135–9.

Eman I Elhawary,Gamal F Mahmoud, Mai A El-Daly, et al Association of HCV with diabetes mellitus: an Egyptian case-control study. Virology Journal 2011;8:367-71

Muhammad SadikMemon, Zain Islam Arain, FarukhNaz,et al. Prevalence of Type 2 Diabetes Mellitus in Hepatitis C Virus Infected Asian Population.

. Journal of Diabetes Research 2013; 9: 7 -10

Ozyilican E, Arslan M. Increased prevalence of diabetes mellitus in patients with chronic hepatitis C virus infection. Am J Gastroenterol 1996; 91:1480–1.

D’Souza R, Sabin A, Foster GR. Insulin resistance plays a significant role in liver fibrosis in chronic hepatitis C and in the response to antiviral therapy. Am J Gastroenterol2005 ;100:1509–15.

EndaleKassa, Abate Bane, HailuKefene. Common genotypes and treatment outcomes of HCV infection among Ethiopians. Ethiop Med J, 2016 ;54: 1

Bigam DL, Pennington JJ, Carpentier A, et al. Hepatitis C-related cirrhosis: a predictor of diabetes after liver transplantation. Hepatology2000 ;32:87–90.

Khalidi M, Lim JW, Bass N, et al. New onset diabetes mellitus after liver transplantation: the critical role of hepatitis C infection. Liver Transpl2004 ;10: 349–55.

Antonelli A, Ferri C, Fallahi P, et al. Hepatitis C virus infection, evidence for an association with type 2 diabetes. Diabetes Care 2005 ;28:2548–50.

Chen LK, Hwang SJ, Tsai ST, et al. Glucose intolerance in Chinese patients with chronic hepatitis C. World J Gastroenterol 2003; 9:505–8.

Zein CO, Levy C, Basu A. Chronic hepatitis C and type II diabetes mellitus: a prospective cross-sectional study. Am J Gastroenterol 2005; 100:48–55.

Shintani Y, Fujie H, Miyoshi H, et al. Hepatitis C virus infection and diabetes: direct involvement of the virus in the development of insulin resistance. Gastroenterology 2004 ;126:840–8.

Maeno T, Okumura A, Ishikawa T, et al. Mechanisms of increased insulin resistance in non-cirrhotic patients with chronic hepatitis C virus infection. J GastroenterolHepatol2003; 18:1358–63.

Narita R, Abe S, Kihara Y, et al. Insulin resistance and insulin secretion in chronic hepatitis C virus infection. J Hepatol 2004; 41:132–8.

Delgado-Borrego A, Casson D, Schoenfeld D, et al. Hepatitis C virus is independently associated with increased insulin resistance after liver transplantation. Transplantation 2004; 15:703–10.

Petit JM, Bour JB, Galland-Jos C, et al. Risk factors for diabetes mellitus and early insulin resistance in chronic hepatitis C. J Hepatol 2001; 35:279–83.

Knobler H, Zhornicky T, Sandler A. Tumor necrosis factor--induced insulin resistance may mediate the hepatitis C virus-diabetes association. Am J Gastroenterol 2003; 98:2751–6.

Knobler H, Schattner A. TNF-, chronic hepatitis C and diabetes: a novel triad. QJM 2005; 98:1–6.

Abate Bane, AravindPatil ,MahafrozKhatib. Healthcare cost and access to care for viral hepatitis in Ethiopia.International Journal of Innovation and Applied Studies 2014 ; 9 : 1718-1723






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