Prevalence of type 2 diabetes mellitus in adult patients with hepatitis C virus infection and associated laboratory markers. Experience at Rwanda Military Hospital: A cross sectional descriptive study

Abstract

Background: Type 2 diabetes Mellitus and hepatitis C co-morbidity remains a public healthproblem globally and they are both associated with significant morbidity and mortality. Anecdotally, in Rwanda referral hospitals, HCV infection has been found in different cases of type 2 diabetes mellitus. Hence, the first study to be carried out in Rwanda Military Hospital (RMH) to describe such cases. This study aims at determining the prevalence of diabetes mellitus among adult patients with hepatitis C infection and assessment of the impact of hepatitis C-type 2 diabetes co-morbidity on selected biochemistry and imaging parameters. Methods: This was a 10 months cross sectional study including consecutive adult patients (18years and above) with hepatitis C Virus infection who presented in Outpatients specialized hepatitis C clinic and internal Medicine admission wards. Participants were considered to have diabetes if they were on diabetic treatment or if they exhibited Fasting blood glucose ≥ 126mg/dl and glycated haemoglobin ≥ 6.5%. All patients were tested for lipid profile and liver function. They underwent also an abdomen ultrasounds. . SPSS version 16.0 was used for data analysis and we compared two groups (those with diabetes and those without diabetes) regarding laboratory and imaging results. Results: Among 298 participants with hepatitis C, 67 (22.48%) had type 2 diabetes. Mostpatients with type 2 diabetes -hepatitis C co-morbidity showed increased levels of Aspartate aminotransferase (AST) (53.7% of patients with co-morbidity versus 35.5% of those with Hepatitis C alone; P<0.007), increased gamma glutamyltransferase (50.7% of patients with co morbidity versus 30.4% of hepatitis C standalone group; P= 0.002) , reduced levels of serum albumin (18.2% in co-morbid group versus 10% in isolate Hepatitis C group ; P<0.005). High levels of total cholesterol and triglyceride were most prevalent in co-morbid group; respectively 29.9% versus 3% (P<0.001) and 23.90% versus 2.60%, P<0.001). In addition, a greatest number of patients with co affection had fatty liver as per ultrasound (63.4% versus 36.60% HCV; P<0.001). Conclusion: Type 2 diabetes mellitus is prevalent in adult patients with hepatitis C atRwanda Military Hospital and its co-existence with hepatitis C would have conjunctive negative impact on liver function as well as on the lipid metabolism. However, there is a need of further deep studies to understand the pathophysiological mechanism.