Hepatitis C-related cirrhosis: A predictor of diabetes after liver transplantation

Hepatitis C virus (HCV) infection has recently been suggested to be a risk factor for the development of diabetes mellitus. The aim of our study was t o investigate whether the prevalence of diabetes is increased among liver t ransplant recipients infected with HCV, We compared the prevalence of diabe tes among 278 liver transplant recipients whose original cause of liver fai lure was HCV infection (110 patients), hepatitis B virus infection (HBV; 53 patients), and cholestatic liver disease (CLD; 115 patients). The pretrans plantation prevalence of diabetes was higher in the HCV group (29%) compare d with the HBV (6%) and CLD (4%) groups (P < .001), The prevalence of diabe tes remained higher in the HCV group 1 year after transplantation: 37%, 10% , and 5% in the HCV HBV, and CLD groups, respectively (P < .001), The cumul ative steroid dose during the first year of transplantation was significant ly lower in the HCV group compared with the CLD group. Multivariate analysi s revealed that HCV-related liver failure (P = .002), pretransplantation di abetes (P < .0001), and male sex (P = .019) were independent predictors of the presence of diabetes I year after transplantation. The high prevalence of diabetes persisted in the HCV group, with 41% diabetic at 5 years. The m ajority of patients with diabetes mellitus (89%) required insulin therapy a fter transplantation. Patient and graft survival rates were similar among p atients with and without diabetes. In conclusion, our study shows that ther e is a high prevalence of diabetes among liver transplant recipients infect ed with HCV both before and after transplantation.