Journal of the American Society of Nephrology, 05/15/2002, By Robert Short
Hepatitis C virus accounts for the increased rate of diabetes mellitus observed with tacrolimus-treated kidney transplant recipients.
Dr Roy Bloom and colleagues of the Renal-Electrolyte and Hypertension Division, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania undertook a retrospective study of 427 kidney recipients. None had diabetes before transplantation.
The patients were studied to examine the interaction between hepatitis C virus and the use of tacrolimus as maintenance therapy with respect to post-transplant diabetes mellitus (PTDM) by 12 months after transplantation.
PTDM occurred in 39.4 percent of patients positive for hepatitis C virus and just 9.8 percent of hepatitis C negative patients. Multivariate logistic regression showed hepatitis C virus, weight at transplantation, and tacrolimus were associated with PTDM. The adjusted odds ratio for hepatitis C virus was especially high: 5.58; 95 percent CI 2.63-11.83; P=0.0001. Dr Bloom said, “A significant interaction was detected between hepatitis C virus status and tacrolimus use for the odds of PTDM”. He added that among the hepatitis C virus positive patients, PTDM occurred more often in patients treated with tacrolimus (57.8 percent) than with cyclosporine A (7.7 percent). The PTDM rates in hepatitis C negative patients were similar in patients treated with tacrolimus and those treated with cyclosporine A (about 10 percent in both groups.
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