Giannini Edoardo Giovanni, Mangia Alessandra, Morisco Filomena, Toniutto Pierluigi, Avogaro Angelo, Fagiuoli Stefano, Borghi Claudio, Frigerio Francesca, Nugnes Marta, Veronesi Chiara, Cappuccilli Maria, Andretta Margherita, Bacca Marcello, Barbieri Antonella, Bartolini Fausto, Chinellato Gianmarco, Ciaccia Andrea, Lombardi Renato, Mancini Daniela, Pagliaro Romina, Ubertazzo Loredana, Degli Esposti Luca, Ponziani Francesca Romana
Gastroenterology Unit, Department of Internal Medicine, University of Genoa, 16126 Genoa, Italy.
Liver Unit, Department of Medical Sciences, Fondazione "Casa Sollievo della Sofferenza" IRCCS, 71013 San Giovanni Rotondo, Italy.
Medicina (Kaunas). 2025 Mar 28;61(4):614. doi: 10.3390/medicina61040614.
: HCV infection represents a main risk factor for type 2 diabetes (T2D). This real-world analysis investigated the HCV-positive (HCV+) population with a T2D co-diagnosis in Italy. : From 2017 to 2021, HCV+ patients were identified from administrative databases and stratified into T2D-HCV+ and HCV+-only cohorts in the presence/absence of a T2D diagnosis. Both cohorts were further divided by treatment with direct-acting antivirals (DAAs). The subgroups were compared for demographic variables, comorbidity profiles, most frequent hospitalizations, and drug prescriptions before inclusion. A sensitivity analysis was performed on patients included after 2019, the year of widespread use of pangenotypic DAAs. : Considering HCV+ patients aged ≥55 years, T2D-HCV+ patients (N = 1277) were significantly ( < 0.001) older than HCV+-only (N = 6576) ones and burdened by a worse comorbidity profile (average Charlson index: 1.4 vs. 0.3, < 0.05). Moreover, regardless of T2D presence, DAA-treated patients were older ( < 0.001) and had a worse Charlson index than the untreated ones. T2D-HCV+ patients showed tendentially higher hospitalization rates and co-medication prescriptions compared to the HCV+-only patients. After 2019, a trend towards reduced co-medication use in DAA-treated patients was noticed, especially antibiotics and cardiovascular drugs. : The co-presence of T2D in HCV+ patients resulted in a worse clinical status, as confirmed by the more frequent requirement of hospitalizations and complex polypharmacy regimens.
丙型肝炎病毒（HCV）感染是2型糖尿病（T2D）的主要危险因素。本真实世界分析调查了意大利合并T2D诊断的HCV阳性（HCV+）人群。：2017年至2021年，从行政数据库中识别出HCV+患者，并根据是否存在T2D诊断将其分层为T2D-HCV+和仅HCV+队列。两个队列进一步根据直接作用抗病毒药物（DAA）治疗进行划分。比较了各亚组纳入前的人口统计学变量、合并症概况、最常见的住院情况和药物处方。对2019年（泛基因型DAA广泛使用的年份）之后纳入的患者进行了敏感性分析。：对于年龄≥55岁的HCV+患者，T2D-HCV+患者（N = 1277）比仅HCV+患者（N = 6576）年龄显著更大（<0.001），且合并症情况更差（平均Charlson指数：1.4对0.3，<0.05）。此外，无论是否存在T2D，接受DAA治疗的患者年龄更大（<0.001），Charlson指数比未治疗的患者更差。与仅HCV+患者相比，T2D-HCV+患者的住院率和联合用药处方往往更高。2019年之后，注意到接受DAA治疗的患者联合用药使用有减少的趋势,尤其是抗生素和心血管药物。：HCV+患者中T2D的共存导致临床状况更差，住院需求更频繁和复杂的多药治疗方案证实了这一点。
