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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: Dr Flamm1 did not discuss the association between chronic HCV infection and diabetes mellitus, nor its mechanism. Several studies from different parts of the world have found that 13% to 33% of patients with chronic HCV infection have associated diabetes, mostly type 2 diabetes.2,3 The increased prevalence of diabetes in patients with HCV without cirrhosis or other confounding factors3 is important as cirrhosis is commonly associated with impaired glucose tolerance, regardless of etiology. Thus, diabetes appears to be a unique extrahepatic manifestation of chronic HCV infection. The National Health and Nutrition Examination Survey III study4 has estimated an adjusted odds ratio of 3.37 of diabetes in patients older than 40 years with chronic HCV infection.