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September 17, 2003

Clinical Aspects of Chronic Hepatitis C InfectionClinical Aspects of Chronic Hepatitis C Infection

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;290(11):1452. doi:10.1001/jama.290.11.1452-a

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