Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: In his Contempo Updates article
about chronic hepatitis C virus (HCV), Dr Flamm1 did
not discuss the association between HCV infection and diabetes. For instance,
Mason et al2 reported that HCV infection
was associated with diabetes. They also found that HCV genotype 2a was observed
in 29% of patients with HCV-RNA–positive diabetes vs 3% of controls
with local HCV infections. Similarly, Bigam et al3 found
that among liver transplant recipients, pretransplant prevalence of diabetes
was higher in the HCV group (29%) compared with the hepatitis B (6%) group.
The prevalence of diabetes remained higher in the HCV group 1 year after transplantation.
Moreover, Flamm did not mention that smoking is independently associated with
elevated alanine aminotransferase levels in HCV-seropositive individuals.
Patients who are seropositive for anti-HCV are strongly advised not to smoke.4
Kashyap AS, Anand KP, Kashyap S. Clinical Aspects of Chronic Hepatitis C InfectionClinical Aspects of Chronic Hepatitis C Infection. JAMA. 2003;290(11):1452. doi:10.1001/jama.290.11.1452-a