HCV and diabetes. A two-question-based reappraisal

Area of Science:

• Hepatology
• Endocrinology
• Public Health

Background:

• Hepatitis C virus (HCV) infection can induce insulin resistance, complicating diabetes management.
• The relationship between HCV and type 2 diabetes (T2D) requires clarification for effective screening strategies.

Purpose of the Study:

• To determine if individuals with T2D should be screened for HCV.
• To assess if HCV-positive individuals should be screened for diabetes.

Main Methods:

• Review of available studies to address clinical questions regarding HCV and diabetes screening.
• Analysis of factors influencing the decision for screening in both directions.

Main Results:

• HCV screening in diabetics is not broadly recommended due to HCV not being directly diabetogenic and insufficient evidence of antiviral treatment efficacy for T2D recovery.
• Screening for T2D in HCV-positive individuals may benefit those with cirrhosis, potentially improving prognosis and reducing mortality.
• HCV screening should be limited to lean diabetics with advanced liver disease.
• Glucose tolerance testing is recommended for HCV-infected individuals with cirrhosis.

Conclusions:

• HCV screening is best reserved for specific diabetic populations (lean, with advanced liver disease).
• Diabetes screening is indicated for HCV-infected patients, particularly those with cirrhosis.
• Further studies are necessary to establish cost-effective screening protocols.