IS THERE A ROLE FOR ISLET CELL ANTIBODIES (ICA) IN HEPATITIS C VIRUS-DIABETES MELLITUS, MYSTERIOUS LINK?
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There is increasing evidence of strong association between hepatitis C virus (HCV) and diabetes mellitus particularly, non-insulin dependent diabetes mellitus (NIDDM), the cause of which is still obscure. Auto-antibodies of different types have been screened in patients with HCV. The presence of islet cell antibodies (ICA) in diabetics has been the focus of widespread interest This study was conducted to clarify the possible role of ICA in this association and to find any correlation between ICA and other autoantibodies. We studied 48 patients with HCV as iagnosed by RIBA ll and PCR . Patients were divided into group I (NIDDM group) and group II (Non diabetic group). Group I comprised 14 males and 10 females with a mean age of 39.75 + 6 years. Group II comprised 16 males and 8 females with a mean age of 39.60 + 5.8 years. Non of the patients received antiviral therapy. They were tested for : Blood glucose , Liver functions ( ALT, AST, Alkaline Phosphatase, Albumin and Prothrombin time). The followin non organ-specific autoantibodies were screened :Anti-mitochondrial antibodies (AMA), Antismooth muscle antibodies (ASMA), and Antinuclear antibodies (ANA) . Islet cell antibodies (ICA) were screened in their sera by indirect immunoflurescence test (Inova Lite, Research kit). The results of the study showed relatively increased prevalence of ICA in group 1(33.3%) than in group II (12.5%), but the difference was statistically non significant (P>0.05). In group I AMA,ASMA, and ANA were positive in 8.3%, 41.6%, and 20.8% respectively, while in group II they were positive in 8.3%, 37.5% and 16.7% respectively, with no statistical significant difference between both groups. ICA correlated ignificantly with ASMA in both groups and with ANA only in group II. No correlation was detected between ICA and AMA. Neither /CA nor other studied auto-antibdies did con-elate to any of the studied liver functions. In Group I, ICA did no correlate to either patient's age, sex or family history of diabetes. In conclusion: (1) The HCV-Diabetes ellitus Link deservescareful evaluation. (2) ICA alone could not explain the relatively high incidence of diabetes mellitus in CV patients. (3) ICA might be present in the sera of HCV patients as a part of immune disturbances present in the disease (3) There is a significant con- ation between ICA and ASMA (4) HCV might trigger an autoimmune phenomena that persist even after cessation Of the disease activity (5) Other pos ible mechanisms for IICVDiabetes Mellitus Link might be: iron overload, metabolic effect, receptor and/or post-receptor effect, viral pancreatitis or HLA ssociation.