Snapshots —Alan Franciscus, Editor-in-Chief

Abstract: Hepatitis C Virus Antibody Positivity and Predictors Among Previously Undiagnosed Adult Primary Care Outpatients: Cross-Sectional Analysis of a Multisite Retrospective Cohort Study—B. Smith et al.
  Source: Clin Infect Dis. 2015 Jan 16. pii: civ002. [Epub ahead of print]

Prior to ‘Baby Boomer’ age-based testing the Centers for Disease Control and Prevention (CDC) recommended that everyone with specific risk factors should be tested for hepatitis C antibodies.  The current study analyzed data between 2005 and 2010 in 4 primary care service sites.  The records included people who had no documented evidence of a prior diagnosis of hepatitis C. 

There were 209,076 patients observed for 5 months—17,464 patients were tested for HCV—6.4% (1,115 people) tested as HCV antibody positive.  Factors associated with a positive HCV antibody test were injection drug use, 1945-1965 birth-cohort (Baby Boomers), and elevated ALT enzymes.  The researchers commented that, “In these outpatient primary settings risk-based testing may have missed 4 of 5 newly enrolled patients” who were HCV antibody positive.
 
Editorial Comment:  Age-based testing has been slow to catch on.  Hopefully, this study will help to dispel the naysayers and speed up the implementation of testing.  Just imagine if we could get all those undiagnosed people identified and into medical care, management and treatment.
 
Abstract:  Interferon therapy in hepatitis C leading to chronic type 1 diabetes—T Zornitzki et al.
  Source:  World J Gastroenterol. 2015 Jan 7;21(1):233-9. doi: 10.3748/wjg.v21.i1.233.

Interferon-based therapy is known to exacerbate some autoimmune diseases. A recent study reviewed published data from 1992 to December 2013 to see if there was a correlation between interferon treatment and type1 diabetes. 

Type 1 diabetes is an autoimmune disease—that is the body’s immune system attacks the pancreas and prevents it from producing insulin to process carbohydrates or sugars.  Type 1 diabetes patients must inject insulin to process the sugars. 

One hundred and seven cases of type 1 diabetes were identified.  This meant that interferon treatment increased the risk of type 1diabetes by 10 to18-fold compared to the general population developing type 1 diabetes.  The patients diagnosed with type 1 diabetes required insulin therapy.  Most of the patients (105 of 107 patients) continued to take insulin permanently (at year 4 of follow-up).
 
Editorial Comment:  This is the first study that has found an association between interferon therapy and type 1 diabetes.  If people did develop type 1 diabetes or another autoimmune disease during or right after treatment and didn’t know the reason, interferon may very well be the cause.  Thankfully, we now have interferon-free therapies so we don’t have to worry about these types of treatment-related auto-immune conditions. 

http://hcvadvocate.org/news/newsLetter/2015/advocate0215_mid.html#5

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