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The susceptibility of patients with type-2 diabetes to hepatitis C virus infection during long-term haemodialysis.

BACKGROUND
Type-2 diabetes has emerged as the commonest cause of end stage renal disease (ESRD) requiring long-term haemodialysis (HD) that constitutes a high-risk environment for the transmission of hepatitis C virus (HCV). The likelihood of acquiring HCV infection in this rapidly growing population on HD conceivably vulnerable to viral infections has not been well studied. The present study aims to determine the susceptibility of the patients with type-2 diabetes to HCV infection in a HD unit with high HCV prevalence.


METHODS
The records of 196 patients with ESRD enrolled on long-term HD at King Fahad Hospital and tertiary care centre, in Hofuf, Saudi Arabia, from November1995 to November 2000, were retrospectively reviewed. HCV prevalence, seroconversion rates, history of blood transfusion, and time on dialysis (time span since initiation of HD therapy) were recorded and compared between the group of patients with type-2 diabetes, and the non-diabetic group.


RESULTS
The overall, HCV seroprevalence of 41.3% (81/196) and annual seroconversion rate of 8.26% were observed. Anti-HCV positivity was associated with longer time on dialysis. Of the 196 patients 54 (27.5%) had type-2 diabetes mellitus and 142 (72.5%) were non-diabetics. Patients with type-2 diabetes recorded higher HCV prevalence (57.4% vs 35.2%), and annual seroconversion rates (11.48% vs 7.04%) after a shorter period on dialysis (32.6 vs 50.6 months), as compared to those of the non-diabetic group.


CONCLUSIONS
A significantly higher HCV prevalence [odds ratio (OR)-2.462, 95% CI (1.338- 4.542)] and annual seroconversion rate [OR-2.483, 95% CI (1.241-4.946)] despite relatively shorter period on dialysis [OR-3.320, 95% CI (1.487-7.4810)] among patients with type-2 diabetes clearly point to the greater likelihood of their acquiring HCV infection even at an earlier stage than the non-diabetic patients, receiving treatment in a high prevalence HD unit.