Abstract and Introduction
Abstract
Hepatitis C virus (HCV) infection is a major health care issue in liver and kidney transplantation. Besides negatively affecting both patient and graft survival, HCV is associated with a heightened risk for new onset diabetes mellitus (NODM). The mechanisms underlying the diabetogenicity of HCV are complex but are likely to involve insulin resistance caused by inhibitory actions of the virus on insulin regulatory pathways in the liver. The resultant glucose dysregulation is an important determinant of increased morbidity and mortality in liver and kidney recipients. This review highlights the concerns for outcomes in HCV-positive liver and kidney transplant patients with particular focus on the interrelationship between hepatitis C and diabetes. Data about the potential role of calcineurin inhibitors, corticosteroids and mycophenolate mofetil in HCV infection and HCV-associated NODM will also be discussed.
Introduction
Hepatitis C virus (HCV) infection is a major health care issue in transplantation. There is abundant evidence that HCV infection is linked to an increased risk of mortality and morbidity in both liver and kidney recipients. The purpose of this review is to examine the impact of HCV infection on outcomes in liver and kidney transplantation, with a specific emphasis on the association between HCV and new onset diabetes mellitus (NODM). We shall additionally consider the potential mechanisms linking NODM and HCV, as well as the role of calcineurin inhibitors (CNIs), corticosteroids and mycophenolate mofetil (MMF) in HCV infection and HCV-associated NODM.