icon-folder.gif   Conference Reports for NATAP  
  DDW Liver Conference
San Francisco, May 19-22, 2002
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Reported by Jules Levin
  We know that persons with HIV are experiencing higher rates of diabetes, glucose abnormalities, and other metabolic abnormalities. In Hepatitis C, elevated glucose and diabetes are associated. A French research group including Thierry Poynard reported at this year's DDW conference on the association between high glucose and liver disease fibrosis. 710 patients with chronic hepatitis C and no HIV or HBV coinfection were retrospectively studied. 55% of patients had no or minimal fibrosis (Metavir F0 or F1) and 45% had septal fibrosis (F2, F3 or F4). Independent risk factors of septal fibrosis were: age (p<10-3), daily alcohol (p<10-3), serum glucose (p=0.003), anti-HBc (p=0.04) and male sex (p=0.04). BMI (p<10-3; r=0.26), serum triglycerides (p=0.002; r=0.12), serum ferritin (p<10-3; r=0.18) and steatosis (p<10-3; r=0.16), were associated with serum glucose but did not independently predict septal fibrosis.
After adjustment for the duration of infection, patients with serum glucose >6.1 mmol/l had a faster progression to septal fibrosis than those with normal serum glucose (p<10-3 by log rank test). Multivariate analysis by the Cox model showed that age at infection >30 yrs. (p<10-3), male sex (p<10-3), daily alcohol >50 g (p=0.02) and serum glucose >6.1 mmol/l (p<0.05) were independently associated with septal fibrosis.
A separate, per fibrosis stage showed that serum glucose >6.1 mmol/l was associated with intermediate (F3) and advanced (F4) but not with early (F2) fibrosis stages. The authors concluded that in patients with chronic hepatitis C, high serum glucose independently predicts liver fibrosis and might explain some of the individual variability in fibrosis progression. High serum glucose might play a role in intermediate and advanced rather than early fibrogenesis and best accounts for the fibrogenic effect of overweight and related metabolic complications.