Prevalence of Hepatitis C Infection and its Genotypes in Suspected Hemodialysis Patients, Southwest of Iran

Background: Hemodialysis patients are more prone to Hepatitis C Virus (HCV) infection due to the need for long-term hemodialysis and blood transfusions. Objectives: The present study aimed to determine the HCV infection burden, viral load, and genotype pattern in hemodialysis patients referred to a research center from 2011 to 2018. Methods: Among 131 hemodialysis patients with suspected HCV infection, referred to Prof. Alborzi Clinical Microbiology Research Center, Shiraz, Iran, from 2011 to 2018, the HCV rate was assessed with the enzyme-linked immunosorbent assay and the HCV RNA load and genotypes by one-step TaqMan real-time PCR. Results: The prevalence of HCV-Ab positivity was 29% among hemodialysis patients, of whom 21 (57%) were HCV RNA-positive. In the rest of the hemodialysis patients who were HCV-Ab-negative, the HCV RNA was detected in five (12%) patients. Genotype 3 (Gt-3) was the most prevalent one detected in 50% of the patients whose genotypes were determined. Also, the HCV viral load in HCV-seropositive patients was generally higher than that in HCV-seronegative ones. Conclusions: This study showed that high HCV infection and different genotype patterns among hemodialysis patients compared to the general population are the main predictors of HCV infection, which indicates healthcare facility transmission because of inappropriate infection management practices.

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Comparative analysis of the interleukin-28b gene alleles in patients with hepatitis C monoinfection and combined HIV/hepatitis C infection

Kazan medical journal ◽

10.17816/kmj2177 ◽

2013 ◽

Vol 94 (3) ◽

pp. 316-320

Author(s):

V K Fazylov ◽

E R Manapova ◽

S V Tkacheva ◽

F M Yakupova ◽

A T Beshimov

Keyword(s):

Viral Load ◽

Comparative Analysis ◽

Hepatitis C ◽

Absolute Number ◽

Hcv Infection ◽

Hcv Rna ◽

Hepatitis C Infection ◽

Genotype 3 ◽

Median Percentage ◽

Baseline Activity

Aim. To identify the frequency and to perform the comparative analysis of IL-28B genotypes distribution in patients with hepatitis C (HCV) mono-infection and combined HIV/HCV infection. Methods. 101 patients (65% - males, average age 33.85±0.62 years) were included in the study. The first group (n=58) - patients with HCV mono-infection, second (n=43) - patients with combined HIV/HCV infection. Single nucleotides polymorphism at rs8099917 and rs12979860 locuses of IL-28B gene was performed using the «AmpliSens Genoscreen-IL28V-FL» reagent kit in the viral hepatitis laboratory of the molecular diagnostics department, CSRIE, Moscow. The baseline activity of HCV infection was determined by RNA-HCV viral load 400 000 copies/mL and alanine aminotransferase level (ALT). In the first group high RNA-HCV viral load (400 000 copies/mL) was observed in 30 (51.7%) patients, mean ALT level was 72.79±9.85 U/L; in the second group high HCV-RNA viral load was detected in 35 (81.4%) patients, mean ALT level was 85.46±7.73 U/L. In the group with combined infection 26 (60.5%) of patients received antiretroviral therapy (ART); in 14 (53.8%) of them there was no detectable viral load. The median absolute number of CD4+ lymphocytes was 0.400±0.04 cells/μL, median percentage - 25.41%±2.41. In 17 (39.5%) treatment-naïve patients the viral load was low (10 000 copies/mL), in 11 (64.8%) of these patients mean CD4+ count was 0.470±0.04 cells/μL (25.33%±2.15); the term of HIV antibodies detection was 6.89±0.53 years. The sensitivity of the PCR method for the qualitative detection of HCV-RNA was 111.1 copies/mL, quantitative - 275 copies/mL, for HIV-RNA - 150 copies/mL. Results. In patients with HCV mono-infection the rate of unfavorable IL-28B CT and TT rs12979860 genotypes and ТG and GG rs8099917 genotypes was 45 (77.6%) и 26 (44.8%) correspondingly, favorable СС rs12979860 and ТТ rs8099917 genotypes were registered in 13 (22.4%) and 32 (55.1%) patients correspondingly. In patients with HIV/HCV infection (n=43) unfavorable IL-28B CT and TT rs12979860 genotypes and ТG and GG rs8099917 genotypes were detected in 20 (46.5%) и 13 (30.2%) of cases, and favorable СС rs12979860 and ТТ rs8099917 genotypes - in 23 (53.5%) and 30 (69.8%) of cases correspondingly. Conclusion. Results show that favorable CC rs12979860 and TT rs8099917 genotypes of the IL-28B and their combination are found quite frequently in patients with mixed HCV/HIV infection, particularly in patients with HCV genotype 3, these patients also had more significant inflammatory reaction and high HCV RNA viral load compared to HCV mono-infected patients.

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Prospective study of hepatitis C virus infection in hemodialysis patients by monthly analysis of HCV RNA and antibodies

Canadian Journal of Microbiology ◽

10.1139/w03-065 ◽

2003 ◽

Vol 49 (8) ◽

pp. 503-507 ◽

Cited By ~ 25

Author(s):

Regina Moreira ◽

João Renato Rebello Pinho ◽

Jorge Fares ◽

Isabel Takano Oba ◽

Maria Regina Cardoso ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Hemodialysis Patients ◽

Hcv Infection ◽

Hcv Rna ◽

Hepatitis C Virus Infection ◽

Serum Samples ◽

Hcv Genotypes ◽

High Prevalence ◽

Time Required

The aims of this study were to (i) evaluate the prevalence and the incidence of hepatitis C virus (HCV) infection in hemodialysis patients in two different centers in São Paulo (Brazil), (ii) determine the time required to detect HCV infection among these patients by serology or PCR, (iii) establish the importance of alanine aminotransferase determination as a marker of HCV infection, and (iv) identify the HCV genotypes in this population. Serum samples were collected monthly for 1 year from 281 patients admitted to hospital for hemodialysis. Out of 281 patients, 41 patients (14.6%) were HCV positive; six patients seroconverted during this study (incidence = 3.1/1000 person-month). In 1.8% (5/281) of cases, RNA was detected before the appearance of antibodies (up to 5 months), and in 1.1% (3/281) of cases, RNA was the unique marker of HCV infection. The genotypes found were 1a, 1b, 3a, and 4a. The presence of genotype 4a is noteworthy, since it is a rare genotype in Brazil. These data pointed out the high prevalence and incidence of HCV infection at hemodialysis centers in Brazil and showed that routine PCR is fundamental for improving the detection of HCV carriers among patients undergoing hemodialysis.Key words: HCV genotypes, hemodialysis, hepatitis C, PCR, prevalence, incidence.

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Characterization of Occult Hepatitis C Virus (Hcv) Infection among Hemodialysis Patient

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v16i1.1138 ◽

2017 ◽

Vol 16 (1) ◽

Author(s):

Siti Nurul Fazlin Abdul Rahman ◽

Hairul Aini binti Hamzah ◽

Mohammed Imad Mustafa ◽

Mohamed Hadzri Hasmoni

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Hemodialysis Patients ◽

Hcv Infection ◽

Viral Rna ◽

Cell Counting ◽

Hcv Rna ◽

Viral Rnas ◽

Occult Hepatitis ◽

Occult Hepatitis C

Introduction: The existence of new entity called occult hepatitis C virus (HCV) has become a raising and escalating concern among healthcare professionals worldwide. It is defined by the presence of viral RNA in liver and/or peripheral blood mononuclear cells (PBMCs) within non HCV-infected patients. Previous study had shown the occult HCV is infectious and capable of transmitting the virus to another host. Till today, HCV infection remains common among hemodialysis patients despite having the best preventive plans. Because of this, there is a significant concern about the source of viral transmission. The aim of the study was to identify and characterize occult HCV infection in PBMC sample of hemodialysis patients. This was an observational and cross sectional study. Materials and method: PBMCs were isolated from the whole blood using Ficoll-gradient centrifugation technique. The PBMCs were then subjected for cell counting and stored in -70O C until further used. HCV RNA were extracted from these cells and viral RNA were subjected for molecular assays, immune cells analysis and cells culture. Results: PBMCs were isolated from eleven (11) study patients and five (5) anti-HCV positive (control) patients. By using automated flow cytometry, PBMCs of each sample were counted and the average number of cells obtained range from 2x104 to 5x106 cells/ ml. Viral RNAs were extracted and quantitatively measured by using NanoDrop Spectrophotometers. The viral RNAs concentration obtained were between 24.7 and 258.9 ng/ml. The RNAs would be subjected for purification (ethanol precipitation) and further assays. Conclusion: The final findings might contribute to the clinical management of dialysis patients.

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Hepatitis C infection among survivors of childhood cancer

Blood ◽

10.1182/blood.v95.10.3065 ◽

2000 ◽

Vol 95 (10) ◽

pp. 3065-3070 ◽

Cited By ~ 69

Author(s):

Donald K. Strickland ◽

Caroline A. Riely ◽

Christian C. Patrick ◽

Dana Jones-Wallace ◽

James M. Boyett ◽

...

Keyword(s):

Liver Disease ◽

Hepatitis C ◽

Liver Function ◽

Childhood Cancer ◽

Normal Liver ◽

Hcv Infection ◽

Hcv Rna ◽

Hepatitis C Infection ◽

Primary Malignancy ◽

Survivors Of Childhood Cancer

Abstract Preliminary reports have suggested that survivors of childhood cancer and aplastic anemia who are infected with the hepatitis C virus (HCV) have a low risk for progression to significant liver disease. Among our surviving patients who were transfused between 1961 and March 1992, 77 (6.6% of surviving patients tested thus far) have evidence of HCV infection, whereas 4 surviving patients who were transfused after March 1992 are HCV-infected. One patient chronically infected with HCV died of liver failure, and 2 patients died of hepatocellular carcinoma. To characterize the risk for these and other complications, 65 patients are enrolled in a longitudinal study of HCV infection, of whom 58 (89.2%) had circulating HCV RNA at the time of protocol enrollment, with genotypes 1A and 1B most commonly isolated. Most enrolled patients have few or no symptoms, carry out normal activities, and have normal liver function. To date, 35 patients have undergone liver biopsy for abnormal liver function since the diagnosis of primary malignancy; central pathology review shows 28 (80%) have chronic active hepatitis, 25 (71%) have fibrosis, and 3 (9%) have cirrhosis. These preliminary data suggest that though most survivors of childhood cancer who are infected with HCV are clinically well, some are at risk for clinically significant liver disease. Identification of other HCV-infected patients and prospective monitoring of this cohort are ongoing to determine the risk for, and to identify factors associated with the progression of, liver disease.

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Patient-Care Practices Associated with an Increased Prevalence of Hepatitis C Virus Infection among Chronic Hemodialysis Patients

Infection Control and Hospital Epidemiology ◽

10.1086/659407 ◽

2011 ◽

Vol 32 (5) ◽

pp. 415-424 ◽

Cited By ~ 29

Author(s):

Gayle Shimokura ◽

Feng Chai ◽

David J. Weber ◽

Gregory P. Samsa ◽

Guo-liang Xia ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Patient Care ◽

The United States ◽

Hemodialysis Patients ◽

Chronic Hemodialysis ◽

Hcv Infection ◽

Hcv Rna ◽

Infection Prevalence ◽

Care Practices

Objective.To identify patient-care practices related to an increased prevalence of hepatitis C virus (HCV) infection among chronic hemodialysis patients.Design.Survey.Setting.Chronic hemodialysis facilities in the United States.Participants.Equal-probability 2-stage cluster sampling was used to select 87 facilities from all Medicare-approved providers treating 30–150 patients; 53 facilities and 2,933 of 3,680 eligible patients agreed to participate.Methods.Patients were tested for HCV antibody and HCV RNA. Data on patient-care practices were collected using direct observation.Results.The overall prevalence of HCV infection was 9.9% (95% confidence interval [CI], 8.2%–11.6%); only 2 of 294 HCV-positive patients were detected solely by HCV RNA testing. After adjusting for non-dialysis-related HCV risk factors, patient-care practices independently associated with a higher prevalence of HCV infection included reusing priming receptacles without disinfection (odds ratio [OR], 2.3 [95% CI, 1.4–3.9]), handling blood specimens adjacent to medications and clean supplies (OR, 2.2 [95% CI, 1.3–3.6]), and using mobile carts to deliver injectable medications (OR, 1.7 [95% CI, 1.0–2.8]). Independently related facility covariates were at least 10% patient HCV infection prevalence (OR, 3.0 [95% CI, 1.8–5.2]), patient-to-staff ratio of at least 7: 1 (OR, 2.4 [95% CI, 1.4–4.1]), and treatment duration of at least 2 years (OR, 2.4 [95% CI, 1.3–4.4]).Conclusions.This study provides the first epidemiologic evidence of associations between specific patient-care practices and higher HCV infection prevalence among hemodialysis patients. Staff should review practices to ensure that hemodialysis-specific infection control practices are being implemented, especially handling clean and contaminated items in separate areas, reusing items only if disinfected, and prohibiting mobile medication and clean supply carts within treatment areas.

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Interferon treatment for chronic hepatitis C infection in hemophiliacs-- influence of virus load, genotype, and liver pathology on response

Blood ◽

10.1182/blood.v87.5.1704.bloodjournal8751704 ◽

1996 ◽

Vol 87 (5) ◽

pp. 1704-1709 ◽

Cited By ~ 1

Author(s):

JP Hanley ◽

LM Jarvis ◽

J Andrew ◽

R Dennis ◽

PC Hayes ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Early Stage ◽

Hcv Infection ◽

Hcv Rna ◽

Interferon Treatment ◽

Hepatitis C Infection ◽

Virus Load ◽

Chronic Hcv

In this study, we assessed the effectiveness of interferon treatment in 31 hemophiliacs with chronic hepatitis C virus (HCV) infection. Interferon alfa-2a (3 MU three times weekly) was administered for 6 months. Response was assessed by both serial alanine transaminase (ALT) and HCV RNA levels measured by a sensitive semiquantitative polymerase chain reaction (PCR) method. HCV genotype was determined by restriction fragment length polymorphism (RFLP), and evidence of changing genotypes during interferon therapy was sought. Severity of liver disease was assessed by both noninvasive and invasive methods, including laparoscopic liver inspection and biopsy. Sustained normalization of ALT levels occurred in eight patients (28%), and seven (24%) became nonviremic as assessed by PCR (<80 HCV/mL). Responders universally cleared HCV RNA within 2 months of starting interferon. Genotype 3a was associated with a favorable response to interferon. No evidence was found for a change in circulating genotype in patients who failed to respond to interferon or who relapsed. This study confirms that response rates to interferon are low in hemophiliacs as compared with other groups with chronic HCV infection. We have also demonstrated that virus load measurement over the first 8 to 12 weeks of treatment is an extremely useful method to identify responders at an early stage.

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COMBINED NS5A & NS5B NUCLEOTIDE INHIBITOR THERAPY FOR PATIENTS WITH CHRONIC HEPATITIS C WITH STAGE 5 CHRONIC KIDNEY DISEASE ON HEMODIALYSIS

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.202000000-08 ◽

2020 ◽

Vol 57 (1) ◽

pp. 39-44 ◽

Cited By ~ 1

Author(s):

Prasanta DEBNATH ◽

Sanjay CHANDNANI ◽

Pravin RATHI ◽

Sujit NAIR ◽

Vinay PAWAR ◽

...

Keyword(s):

Hepatitis C ◽

Transient Elastography ◽

Liver Stiffness ◽

Post Treatment ◽

Hcv Infection ◽

Maintenance Hemodialysis ◽

Hcv Rna ◽

Genotype 3 ◽

Open Label ◽

Genotype 2

ABSTRACT BACKGROUND: Hepatitis C virus (HCV) infection is the most common hepatotropic viral infection affecting the patients on maintenance hemodialysis. Treatment of chronic HCV infection in stage 4 and 5 CKD includes a combination of elbasvir/grazoprevir and glecaprevir/pibrentasvir, which are not available in many countries. OBJECTIVE: Hence, we have conducted this study to look for the safety and efficacy of sofosbuvir combination therapy in this difficult to treat population. METHODS: We conducted a single-center, prospective, open-label study in which Stage 5 CKD patients on maintenance hemodialysis with HCV infection. Total of 18 patients was included. sofosbuvir with daclatasvir or ledipasvir was used according to genotype for 12 weeks. HCV RNA, genotype, transient elastography (TE) was considered for every patient. HCV RNA was quantified at 4th week, 12th week and 12 weeks post-treatment to look for sustained virologic response (SVR 12). RESULTS: Infection due to genotype 1 was seen in 12 (66.7%) patients followed by genotype 3 in 4 (22.3%) with each patient of genotype 2 and 5. The median value of HCV RNA was 2,35,000 IU/mL. On TE, all had liver stiffness of <9.4 KPa. All patients had HCV RNA of <15 IU/mL at 4th and 12th week of treatment and 12 weeks post-treatment. No significant change in hemoglobin, eGFR and liver stiffness was observed. CONCLUSION: Full dose sofosbuvir i.e. 400 mg, in combination with NS5A inhibitors daclatasvir or ledipasvir is found to be safe and effective in patients with end stage renal disease, who are on maintenance hemodialysis.

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Clinical, Biochemical and Virological Profile of Patients with Chronic Hepatitis C Virus Infection - A Study from University Hospital in Nepal

Journal of Nobel Medical College ◽

10.3126/jonmc.v4i1.13301 ◽

2015 ◽

Vol 4 (1) ◽

pp. 32-35

Author(s):

Dipesh Gurubacharya ◽

Mohan Khadka ◽

Khadga B Shreshta ◽

Prem Khadga ◽

Sashi Sharma

Keyword(s):

Hepatitis C Virus ◽

Viral Load ◽

Hepatitis C ◽

Drug Use ◽

Injection Drug Use ◽

Hcv Infection ◽

Genotype 3 ◽

Hcv Genotypes ◽

Chronic Hcv Infection ◽

Chronic Hcv

Introduction: Hepatitis C virus (HCV) infection is a major public health challenge. It is a major cause for cirrhosis and hepatocellular carcinoma worldwide. Both the genotype and viral load of HCV determine the choice of therapy as well as outcome of therapy. The aim of this study was to evaluate clinical, biochemical and virological profile and association of HCV genotypes with viral load and liver biochemical profile.Material and Methods: This was descriptive observational study of chronic HCV infected patients who attended at the outpatient clinic of Department of Gastroenterology of TUTH, IOM from April 2013 to November 2014. During this study period 38 patients with chronic HCV infection were analyzed. Clinical profile, possible risk factors for transmission of HCV infection and liver biochemical profile were recorded. Virological profile included HCV viral load and HCV genotypes.Results: Out of 38 patients 34(89.5%) were male and 4(10.5%) were female. Injection drug use (IDU) was the most common mode for acquisition of HCV infection (55.3%). Genotype 3 was found in 21(55.26%) patients and genotype 1 was found in 17(44.74%) patients. There was no significant association between HCV genotypes and serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) level. And also there was no significant association between HCV viral load and different HCV genotypes.Conclusions: In our study HCV genotype 3 was the most prevalent genotype in patients with chronic HCV infection. Injection drug use was identified as most common identifiable risk factor for transmission of HCV infection. There was no significant association between different HCV genotypes and serum ALT, AST level and HCV viral load. Journal of Nobel College of Medicine Vol.4(1) 2015: 32-35

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Hepatitis C Core Antigen Testing to Diagnose Active Hepatitis C Infection Among Haemodialysis Patients

10.21203/rs.3.rs-33936/v2 ◽

2020 ◽

Author(s):

XZ Wong ◽

CC Gan ◽

R M ◽

R Y ◽

S G ◽

...

Keyword(s):

Hepatitis C ◽

Predictive Value ◽

Hcv Infection ◽

Core Antigen ◽

Hcv Rna ◽

Hepatitis C Infection ◽

Hcv Treatment ◽

Serological Screening ◽

Cross Sectional ◽

Spearman Test

Abstract BACKGROUNDHepatitis C virus (HCV) infects more than 71 million people worldwide and chronic HCV infection increases the risk of liver cirrhosis and failure. Haemodialysis (HD) is one of the renal replacement therapies with risk of HCV transmission. Anti-HCV antibodies are the serological screening test for HCV infection that does not detect active phase of infection. Majority HCV infected HD patients in Malaysia do not have further HCV RNA performed due to high cost and thus HCV treatment is less frequently offered. HCV Core Antigen (HCV Ag) can potentially be used to diagnose active HCV infection in HD population in comparison to HCV RNA, at lower cost. METHODS We conducted a cross-sectional study to assess the correlation between HCV Ag and HCV RNA and to identify the prevalence of active HCV infection among HCV seropositive HD patients from dialysis centres across West Malaysia from July 2019 to May 2020. Pre-dialysis blood was taken and tested for both HCV Ag and HCV RNA tests. HCV Ag was tested with Abbott ARCHITECT HCV Ag test.RESULTS We recruited 112 seropositive HD patients from 17 centres with mean age of 54.04±11.62 years, HD vintage of 14.1±9.7 years, and male constitute 59.8% (67) of the study population. HCV Ag correlates well with HCV RNA (Spearman test coefficient 0.833, p<0.001). The sensitivity was 90.7%, specificity 100%, positive predictive value (PPV) 100%, negative predictive value (NPV) 76.5%, and accuracy 92.9%. For HCV RNA level >3000 IU/mL, HCV Ag had a higher sensitivity of 95.1% and greater correlation (Spearman test coefficient 0.897, p<0.001). The prevalence of active HCV infection was 76.8% among HCV seropositive HD patients. CONCLUSIONS Although HCV Ag is less sensitive, it shows an excellent correlation with HCV RNA and has 100% PPV. HCV Ag can be considered as an alternative diagnostic tool for chronic active HCV infection among HD cohort, who can then be considered for HCV treatment. For seropositive HD patient with negative HCV Ag, we recommend to follow-up with HCV RNA test.

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Studies on the prevalence of Hepatitis C virus infection in diabetic patients attending a tertiary health-care facility South-west Nigeria

BMC Infectious Diseases ◽

10.1186/s12879-020-05388-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

James A. Ndako ◽

Akinyomade O. Owolabi ◽

Joseph A. Olisa ◽

Jeremiah A. Akinwumi ◽

Victor T. Dojumo ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Age Distribution ◽

Care Facility ◽

Health Care Facility ◽

Hcv Infection ◽

Enzyme Linked Immunosorbent Assay ◽

Diabetic Patients ◽

Hepatitis C Infection

Abstract Background Hepatitis C virus (HCV) infection and type 2 diabetes mellitus (T2DM) are two major public health problems associated with increasing complications and mortality rates worldwide. The objective of this study is to evaluate the prevalence of hepatitis C virus (HCV) infection in diabetic patients and to investigate the influence of several epidemiological and clinical factors on HCV infection. Method A total number of one hundred and eighty diabetic patients were recruited for this study. Consented subjects made up of 71(39.4%) males and 109(60.56%) females were recruited for the study. While one-Hundred (100) Non-Diabetics (Controls) were also recruited for the study. Structured questionnaires were administered to the consented participants to obtain relevant data. Sera samples were assayed for antibodies to HCV using an enzyme linked immunosorbent assay [Inteco Diagnostic Limited]. ELISA technique. Result Overall prevalence of HCV infection among diabetes patients assayed was 13.3% out of which 8(11.3%) was obtained from the male subjects compared to 16 (14.7%) seropositivity recorded among the females (P = 0.511; P > 0.05). Considering age distribution, Subjects aged 41–50 years recorded, 9 (22.5%) positivity (P = 0.238; P > 0.05).Considering educational status of subjects screened, 22 (14.9%) positivity was rescored among subjects who have attained tertiary status of education.(P = 0.574;P > 0.05).Risk factors considered showed that, 7 (18.9%) seropositive subject were alcoholic consumers(P value = 0.2621;P > 0.05) while 5 (8.9%) recorded history of sharing sharp objects P = 0.2427;P > 0.05). Conclusion Our study shows a slightly higher prevalence of hepatitis C infection in type 2 diabetics. This call for urgent routine screening exercise among diabetic patients for HCV infection. This study also emphasizes the need for public enlightenment on the association between HCV infection and T2DM, to avert possible complications among diabetic patients.

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