Interferon alpha therapy and Type 1 diabetes in patients with hepatitis C: pathophysiologic insights

Ayse Aytaman, Gul Bahtiyar and Samy I McFarlane

Chronic hepatitis C virus infection is associated with an increased risk for the development of Type 2 diabetes mellitus. Proposed mechanisms include increased insulin resistance, development of nonalcoholic fatty liver disease and direct infection of the pancreas by hepatitis C virus. The development of Type 1 diabetes mellitus, however, is usually associated with therapy with interferon α for hepatitis C virus infection with development of anti islet cell antibodies. The pathogenetic mechanisms underlying this autoimmune destruction of the pancreas is not completely understood. In this review we discuss hepatitis C virus and Type 1 diabetes mellitus, highlighting the role of interferon α therapy in the development of Type 1 diabetes mellitus in hepatitis C virus-infected patients. We will also discuss the mechanism of actions of interferon α as it relates to the development of Type 1 diabetes mellitus in this patient population.