C-reactive protein and chronic hepatitis C virus infection in diabetic patients

INTRODUCTION: C-reactive protein (CRP) is one of the most widely used risk markers of cardiovascular disease in clinical practice. The contribution of hepatitis C virus (HCV) infection to low-grade inflammation in diabetic patients and its significance for cardiovascular risk scoring remain unclear. OBJECTIVES: The aim of the study was to investigate the relationship between HCV infection and CRP levels as one of the markers of cardiovascular risk in diabetic patients. PATIENTS AND METHODS: We compared patients with HCV infection and diabetes (n = 46) with HCV-negative type 1 (n = 56) or type 2 diabetic patients (n = 54), as well as HCV patients without diabetes (n = 54). RESULTS: CRP levels in diabetic HCV patients were lower than in type 2 diabetic patients (P <0.001), similar to those in the type 1 diabetic group (P = 0.747), and higher than in nondiabetic HCV subjects (P = 0.002). The median values were 1.07, 2.58, 0.91, and 0.45 mg/l, respectively. White blood cell count in diabetic HCV subjects was lower than in those with type 2 diabetes (P = 0.029) and similar to that found in type 1 diabetic (P = 0.064) and nondiabetic HCV patients (P = 0.279). There was difference in erythrocyte sedimentation rate between diabetic and nondiabetic HCV groups (P = 0.025); the respective medians were 10 and 5 mm/h. CONCLUSIONS: These findings indicate that HCV hepatitis may modulate chronic inflammatory state in diabetic patients. Moreover, these results suggest that screening for HCV should be considered prior to assessment of cardiovascular risk in diabetic patients, because the results may affect the cardiovascular risk scoring.