This population-based cohort study aimed to investigate whether antiviral therapy for Hepatitics C Virus (HCV) infection was associated with clinical outcomes in diabetes. From the Taiwan National Health Insurance Research Database, 2,267,270 Taiwanese residents diagnosed with diabetes mellitus were screened for eligibility. After excluding patients with serious comorbidity, they enrolled a total of 1,411 eligible patients who received pegylated interferon plus ribavirin (treated cohort), and matched them 1:1 with 1,411 untreated controls by propensity scores (untreated cohort). Participants were followed up for the occurrence of end-stage renal disease (ESRD), ischemic stroke, and acute coronary syndrome (ACS) after receiving antiviral treatment or the corresponding calendar date. The results showed that from 2003 to 2011, the 8-year cumulative incidences of ESRD in the treated, untreated, and uninfected cohorts were 1.1%, 9.3%, and 3.3% respectively; those of stroke were 3.1%, 5.3%, and 6.1%, respectively; and those for ACS were 4.1%, 6.6%, and 7.4%, respectively. As compared with the untreated cohort, antiviral treatment was associated with multivariate-adjusted hazard ratios of 0.16 for ESRD, 0.53 for ischemic stroke, and 0.64 for ACS, respectively. The authors conclude antiviral therapy for HCV improves clinical outcomes in diabetes. Hepatology, October 2013.
