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Hepatitis C and Diabetes

• NHANES III showed that among 9,841 patients older than 20, 8.4% haddia etes and 2.1% had hepatitis ! with an estimated ".# $old in rease in theris& o$ ha'ing or de'eloping (2)* among patients in$e ted with hep !+additionall dia etes and I- were independent predi tors o$ li'er relatedmortalit in H!/ in the same st d 1

• 4 ris& o$ H!! in patients w dia etes and similar in reased in iden e o$dia etes in H!! patients 2

• (rial o$ 1084 ad lts, H!/ positi'e patients at high ris& o$ de'eloping dia etes3 ased on *I and age5 were 11 times more li&el to de'elop dia etes thanH!/ negati'e indi'id als "

• In a meta anal sis o$ "4 st dies $or a total o$ "00,000 patients, pooledestimate o$ (2)* in H!/ patients was an ad6 sted odds ratio o$appro7imatel 1. 8 39 % on:den e inter'al ;!I< 1.1 =2.205, signi: ant in

oth prospe ti'e and retrospe ti'e meta anal ses 4•

20,48 'eterans treated $or H!/ noted a red ed in iden e o$ dia etes3ha>ard ratio 0.# , 9 % !I 0.#0=0.825 in patients a hie'ing S/-• -etrospe ti'e ohort st d o$ 10,2 9 patients showed in rease in

ardio'as lar mortalit among H!/ positi'e lood donors 3ha>ard ratio2.21, 9 % !I? 1.41, ".4 5 and larger arotid intima media thi &ness 3I*(5, aninde7 o$ earl atheros lerosis, in H!/ positi'e patients when ompared withH!/ negati'e ontrols

• St d o$ 1#" patients showed asso iation etween H!/ in$e tion andongesti'e heart $ail re 2.49 31.04= .9 5 t not is hemi heart disease and

stro&e #

(a&e home point? ! ring H!/ ma e asso iated with red ed in iden e o$dia etes and possi l an impro'ed ardio'as lar ris& pro:le.

• ! rrent standard therap ? @atients w *eta'ir s ore 2, triple therap withpeginter$eron and ri a'irin B o epre'ir telapre'ir $or 12 wee&s, i$ noresponse add " w&s

• New (7? (hree trials in l ding 19 2 patients showed Cedipas'ir=so$os 'ir$or 8 wee&s was asso iated with a high rate 3D9 %5 o$ s stained 'irologi

1 illiams I. Am F *ed 1999+10#?2S 9S2 Adami HG et al. F Natl !an er Inst 199 +88?14#2 # and idero C et al. F Natl !an er Inst199#+89?1" 0" *ehta SH et al. Ann Intern *ed 200+1""385 92 994 hite )C et al. F Hepatol. 2008+493 58"1 844.

H der S* et al. astroentereolog . 201"+1443 5S9 1 iltinan A* et al. Am F Epidemiol. 2008+1 #3 5?#4" # 0 and (argher et al. F Hepatol. 200#+

4 3 5?112 11"2# Jo nossi K* et al. Aliment @harma ol (her. 201"+"#3 5? 4# 2.

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response among pre'io sl ntreated patients with H!/ genot pe 1in$e tion witho t irrhosis. 8

!ost ene:t?• Ci$etime ost o$ an indi'id al in$e ted with H!/ in 2011 was estimated at

L 4,490• !ost o$ a 12 wee& regimen o$ so$os 'ir alone is L84,000 and ledipas'ir will

add to ost• )ire t medi al ost o$ dia etes o'er li$etime diagnosed at age 4 4 is

ML84,000 110,000• !ost o$ !H per person per ear is ML4,000 so i$ diagnosed at 0 and li'e to

80, ML80,000

8 Oowdle O/ et al. NEF*. 2014+"#0?18#9 1888.

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