Hepatitis C virus (HCV) infection is the leading cause of chronic liver disease resulting in end-stage cirrhosis and liver cancer, and it remains the primary cause for liver transplantation in the western countries. Chronic HCV infection is believed to be a multi-faceted systemic disease which not only influences the hepatic environment causing inflammation, steatosis and fibrosis but also alters the metabolism of glucose and lipids, leading to metabolic sequelae such as insulin resistance, diabetes and dyslipidaemia. HCV has been identified as an independent risk factor for the development of diabetes in predisposed individuals (with family history and visceral obesity) and it is more prevalent with certain HCV genotypes. Moreover, it can also induce direct destruction of pancreatic β cells and trigger auto-immune reactions by molecular mimicry in the pancreas, leading to auto-immune diabetes. Its immunological effects can also lead to the development of diabetes in patients who had undergone liver transplantation for HCV infection which is further made worse by intense immunosuppression used in such settings.
This article provides an overview of the intriguing relationship between HCV infection and diabetes, the two major public health challenges which lead to widespread health and financial burden worldwide. Copyright © 2016 John Wiley & Sons.