Tuesday, September 12, 2017

High Prevalence of Diabetes Mellitus among Adult Patients with Viral Hepatitis C than Hepatitis B

Golam Azam1*, Shahinul Alam2, Abdullah Saeed Khan3, Rubayat Sheik Giasuddin4, Mobin Khan5
1Associate Professor, Department of Gastrointestinal, Hepatobiliary and Pancreatic Disorders (GHPD), BIRDEM General Hospital, Shahbagh, Dhaka, Bangladesh
2Associate Professor, Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka, Bangladesh
3Research Associate, The Liver Centre, Dhanmondi, Dhaka, Bangladesh
4Assistant Professor, Department of Medicine, Anwer Khan Modern Medical College, Dhaka, Bangladesh
5Professor and Director, The Liver Centre, Dhanmondi, Dhaka, Bangladesh
 *Address for Correspondence: Dr. Golam Azam, Associate Professor Department of Gastrointestinal, Hepatobiliary and Pancreatic Disorders (GHPD), BIRDEM General Hospital, Shahbag, Dhaka- 1000, Bangladesh

ABSTRACT- Background: Viral hepatitis B and C can lead to the end stage liver disease and diabetes mellitus is also a life-long chronic disease. Simultaneous presences of both of these conditions lead to synergistic detrimental outcome. So identification of diabetes mellitus at the initial evaluation of a patient having chronic hepatitis B and C is essential.
Materials and methods: This study was designed as a retrospective single center cross-sectional study. The association of viral hepatitis B and C with diabetes mellitus was investigated at the Liver Centre Dhaka, Bangladesh for a period of 12 years. HBsAg was tested for hepatitis B virus infection and anti-HCV for hepatitis C virus infection. Demographic profile and biochemical data were retrieved from records.
Results:  A total of 29425 cases were analyzed in the study [median age 31(19–95) years, 24615(84%) males]. HBsAg positive were 27475 and hepatitis C were 1950. Patients with hepatitis C were older than hepatitis B (p<0.001). Although previous history of jaundice was similar in both infections but history of blood transfusion was more common among hepatitis C patients (p<0.001). Analyzing different conditions of liver disease, it was observed that hepatitis B virus infection was highly responsible for acute hepatitis than hepatitis C (10.7% vs 1.1%) (p<0.001). Chronic hepatitis was similar in rate (73.3% vs 59.9%). But in both conditions of cirrhosis of liver like compensated and decompensated states, hepatitis C virus was significantly responsible than the hepatitis B virus 24.7% vs 9.6% (p<0.001) and 14.3% vs 6.4% (p<0.001) respectively. The most significant finding was very higher rate of diabetes among hepatitis C which was 22.6% while only 1.8% among hepatitis B virus infection (p<0.001).
Conclusion:  Hepatitis C virus was highly related with the presence of diabetes than hepatitis B.

Key-words- Diabetes mellitus, Prevalence, Hepatitis B virus, Hepatitis C virus