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Assessment of Evidence for Positive Association and Seroprevalence of Hepatitis B and C in Diabetic Patients in a Developing Country
  1. Huseyin Korkmaz, MD*,
  2. Recep Kesli, MD,
  3. Barıs Onder Pamuk, MD,
  4. Suleyman Hilmi Ipekci, MD§,
  5. Yuksel Terzi, PhD,
  6. Levent Kebapcilar, MD§
  1. From the *Department of Internal Medicine, Division of Gastroenterology, Selcuk University, Faculty of Medicine; †Department of Microbiology, Konya Education and Research Hospital, Konya; ‡Department of Internal Medicine, Izmir Katip Celebi University, Faculty of Medicine, Izmir; §Department of Internal Medicine, Division of Endocrinology and Metabolism, Selcuk University, Faculty of Medicine, Konya; and ∥Department of Statistics, Ondokuz Mayis University, Faculty of Science and Arts, Samsun, Turkey.
  1. Received May 20, 2014, and in revised form October 11, 2014.
  2. Accepted for publication October 13, 2014.
  3. Reprints: Huseyin Korkmaz, Selcuk Universitesi, Tıp Fak, Alaeddin Keykubad Kampüsü, 42075 Selçuklu, Konya, Turkey. E-mail: husein68{at}
  4. All authors contributed equally to this work.


Background and Aim The data related to the association between hepatitis virus infections and diabetes mellitus (DM) are conflicting. The aim of this study was to investigate the seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) and to determine the risk factors affecting the prevalence in Turkish patients with type 1 DM and type 2 DM.

Methods The study consisted of 736 diabetic and 505 nondiabetic patients. Serological investigation for the hepatitis B surface antigen (HBsAg) and the HCV antibody (anti-HCV) was performed with a third-generation commercial chemiluminescence assay. The presence of HBsAg was considered as indicator of HBV infection. The HCV infection in the patients with positive anti-HCV was confirmed by a real-time polymerase chain reaction assay. The patients were divided according to their HBV and HCV infection status, and their demographic features, diabetes properties, general risk factors, and aminotransferase levels were analyzed.

Results There was no significant difference in the seropositivity rate for the HBsAg (3.8% vs 3.0%, P > 0.43; odds ratio, 1.292; 95% confidence interval, 0.683–2.444). However, anti-HCV seropositivity was significantly increased in the DM group (3.3% vs 1.8%, P < 0.03; odds ratio, 2.398; 95% confidence interval, 1.025–5.609). Increased aminotransferase levels and a history of blood transfusions were positively correlated with both HBV and HCV infection. Moreover, a history of surgical procedures and high glycated hemoglobin A1c levels were positively associated with HBsAg antigen seropositivity.

Conclusions Although no significant difference in the seropositivity of the HBsAg was determined, a high prevalence of HCV infection was detected in the DM patients compared to healthy controls.

Key Words
  • diabetes mellitus
  • hepatitis B
  • hepatitis C
  • seroprevalence

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