| Statin therapy improves sustained virologic response among diabetic patients with chronic hepatitis C. | |
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MedLine Citation:
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PMID: 20833169 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND & AIMS: Patients with chronic hepatitis C infection are 2- to 3-fold more likely to develop type 2 diabetes, which reduces their chances of achieving a sustained virologic response (SVR). To identify differences in predictors of SVR in patients with and without diabetes who received combination antiviral therapy, we conducted a retrospective analysis of a national Veterans Affairs administrative database. METHODS: We analyzed data from the Veterans Affairs Medical SAS Datasets and Decision Support System for entire cohort and separately for diabetic patients (n = 1704) and nondiabetic patients (n = 6589). Significant predictors of SVR were identified by logistic regression analysis. RESULTS: Diabetic patients had a lower SVR compared with nondiabetic patients (21% vs 27%, respectively, P < .001). Diabetic patients had higher clustering of previously established negative predictors of SVR. On multivariate analysis of diabetic patients for SVR, the positive predictors were higher low-density lipoprotein (odds ratio [OR], 1.45; P = .0129), use of statin (OR, 1.52; P = .0124), and lower baseline viral load (OR, 2.31; P < .001), whereas insulin therapy (OR, 0.7; P = .0278) was a negative predictor. Diabetic patients on statins had higher pretreatment viral loads (log 6.2 vs 6.4, respectively, P = .006) but better early virologic response. There was a graded inverse relationship between Hemoglobin A1c and SVR rate (P = .0482). This relationship was significant among insulin users (P = .0154) and non-significant among metformin users (P = .5853). CONCLUSIONS: Statin use was associated with an improved SVR among both diabetic patients and nondiabetic patients receiving combination antiviral therapy. Diabetic patients who received insulin achieved lower SVR compared with those not receiving insulin. Poor diabetes control was associated with lower SVR rates. |
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Authors:
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Gowtham A Rao; Prashant K Pandya |
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Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, Non-P.H.S. Date: 2010-09-15 |
Journal Detail:
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Title: Gastroenterology Volume: 140 ISSN: 1528-0012 ISO Abbreviation: Gastroenterology Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2010-12-21 Completed Date: 2011-01-20 Revised Date: 2012-05-04 |
Medline Journal Info:
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Nlm Unique ID: 0374630 Medline TA: Gastroenterology Country: United States |
Other Details:
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Languages: eng Pagination: 144-52 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Kansas City Veterans Affairs Medical Center, Kansas City, Missouri, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Antiviral Agents
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therapeutic use* Cohort Studies Diabetes Mellitus, Type 2 / epidemiology, prevention & control*, virology* Drug Therapy, Combination Female Hemoglobin A, Glycosylated / analysis Hepatitis C, Chronic / complications, drug therapy* Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use* Hypoglycemic Agents / therapeutic use Insulin / therapeutic use Interferon-alpha / therapeutic use Longitudinal Studies Male Metformin / therapeutic use Middle Aged Polyethylene Glycols / therapeutic use Recombinant Proteins Retrospective Studies Ribavirin / therapeutic use Treatment Outcome Viral Load / drug effects |
| Chemical | |
Reg. No./Substance:
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0/Antiviral Agents; 0/Hemoglobin A, Glycosylated; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Hypoglycemic Agents; 0/Insulin; 0/Interferon-alpha; 0/Polyethylene Glycols; 0/Recombinant Proteins; 0/hemoglobin A1c protein, human; 0/peginterferon alfa-2a; 0/peginterferon alfa-2b; 36791-04-5/Ribavirin; 657-24-9/Metformin; 76543-88-9/interferon alfa-2a; 99210-65-8/interferon alfa-2b |
| Comments/Corrections | |
Erratum In:
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Gastroenterology. 2011 Apr;140(4):1361 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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