Type 2 diabetes mellitus (T2DM) and hepatitis C virus

Background:A high prevalence of hepatitis C virus (HCV) infection in patients with diabetic kidney disease (DKD) has been reported. However, the epidemiology and relationship between DKD and occult HCV infection (OCI)are unknown.Objetives: To determine the prevalence of OCI in a population without conventional markers of HCV infection diagnosed with DKD, and to study its possible clinical implications.Study design: This prospective study included 125 anti-HCV and serum HCV-RNA-negative patients with DKD for the presence of OCI. HCV-RNA was tested by real-time reverse transcription PCR in peripheral blood mononuclear cells and in plasma after ultracentrifugation. Results: OCI was positive in 10 patients (8%). The patients with OCI had significantly higher ferritin levels (p=.002) and monoclonal gammopathy (30% [3/10] vs. 0.87% [1/115] than the patients without OCI [p=.003]). We found similar plasma ALT and GGT levels and HbA1C in both groups. At the end of the follow-up, the progression rate of renal disease tended to be faster in the group with OCI relative to the negative one, but without a significant difference. We did not find an association between OCI and cardiovascular morbidity. Conclusions: There was an 8% prevalence of OCI in patients with chronic renal failure secondary to DKD, higher than in the general population. This occult infection does not appear to play a role in the control of diabetes, cardiovascular risk or steatosis. However, the progression rate of renal disease tended to be faster, and the incidence of associated monoclonal gammopathy was significant.