There is a high incidence of Diabetes mellitus and vitamin D deficiency seen among Hepatitis C patients. The effect of the simultaneous occurrence of DM and low levels of 25-Hydroxy Vitamin D on HCV related liver disease remains unclear. In this study, we have aimed to assess the influence of DM and levels of Vitamin D on HCV related liver disease patients.Methods
In this retrospective study, all patients who tested positive for Anti-HCV between January 2014 – December 2016 were included and were reviewed for gender, age, diabetes, genotype, level of 25-Hydroxy Vitamin D, the status of liver disease including HCC at inclusion. The association of diabetes and low Vitamin D levels (<30 ng/mL) with liver status and child pugh class (CTP) was analysed.Results
A total of 777 patients were included. At presentation 439 (56%) patients had cirrhosis; including 51 (7%) with HCC and 287 (37%) had chronic hepatitis. 25-Hydroxy Vitamin D level was available in 206 patients at baseline. Low Vitamin D level was present in [126/206 (61%)] of the patients. DM was present in [165/777 (21%)] of the patients and was more common with genotype 1 and 4 (p=0.056). Patients who had associated diabetes presented more commonly with cirrhosis 122/439 (28%) and HCC 122/439 (29%) in comparison to chronic hepatitis 28/287 (10%) (p<0.01). Lower Vitamin D level (<30 ng/mL) was seen in 67% (98/147) of patients with cirrhosis, 78% (11/14) with HCC and 47% (28/59) with chronic hepatitis (p=0.012). In cirrhotic patients, vitamin D deficiency was significant in child B (72%) and Child C (75%) patients in comparison to child a patients (52%) (p=0.013) (figure 1).Conclusions
25-Hydroxy Vitamin D deficiency was present in 61% and diabetes mellitus co-existed in 21% of HCV patients at presentation. Diabetes and low levels of 25-OH vitamin D at presentation were associated with higher incidence of cirrhosis and HCC. We believe that improving diabetes control and correcting vitamin D deficiency can improve outcomes in hepatitis C related liver disease.