The Screening of Diabetes, Obesity, and Hypertension Risks Associated with Hepatitis C Within the Egyptian Population in a Community Pharmacy Setting


Hepatitis C virus




Background: Diabetes and hypertension have been identified as risk factors for HCV complications in previous studies. This has sparked the interest in the field of prevention by identifying at-risk individuals and increasing investments for screening among pharmacists. The aim of this study was to screen for risk factors, including age, gender, BMI, hypertension, diabetes, and obesity, in Egyptian patients with HCV. Methods: A prospective cross-sectional study was carried out from September 2018 to February 2019, with a total of 1,959 medical records collected. By comparing the patients’ characteristics, variables related to metabolic risk, and body composition measurements, regression models have been established to determine any confounding factors. Results: The prevalence of HCV antibody was 41.0% in men and 59.0% in women. Among the variables included in the regression analysis, age, BMI, and uncontrolled hypertension were found to have statistically significant associations with diabetes in HCV positive cases (p < 0.001). HCV patients ? 40 years old with high BMI were found to have significant associations with both, diabetes and hypertension (p < 0.001). Hypertensive HCV patients were found to have significant associations with gender, age ? 40, and DM (p < 0.001). Conclusion: HCV infection and metabolic disorders have a closed cycle relationship. Reducing the complications of DM has a promising prospective of limiting the complications of HCV.


Abdelaziz SB, Galal YS, Sedrak AS, et al., 2015, Association of Hepatitis C Virus Infection and Type 2 Diabetes in Egypt: A Hospital-Based Study. Health Science Journal, 6(01): 77.

McElnay J, Nicholl A, Grainger?Rousseau TJ, 1993, The Role of the Community Pharmacist – A Survey of Public Opinion in Northern Ireland. International Journal of Pharmacy Practice, 2(2): 95-100.

May AL, Kuklina EV, Yoon PW, 2012, Prevalence of Cardiovascular Disease Risk Factors Among US Adolescents, 1999-2008. Pediatrics, 129(6): 1035-1041.

Elgharably A, Gomaa AI, Crossey MM, et al., 2017, Hepatitis C in Egypt – Past, Present, and Future. Int J Gen Med, 10: 1-6.

Benova L, Awad SF, Miller FD, et al., 2015, Estimation of Hepatitis C Virus Infections Resulting from Vertical Transmission in Egypt. Hepatology, 61(3): 834-842.

Petruzziello A, Marigliano S, Loquercio G, et al., 2016, Global Epidemiology of Hepatitis C Virus Infection: An Up-Date of the Distribution and Circulation of Hepatitis C Virus Genotypes. World J Gastroenterol, 22(34): 7824.

Ayoub H, Abu?Raddad LJ, 2017, Impact of Treatment on Hepatitis C Virus Transmission and Incidence in Egypt: A Case for Treatment as Prevention. J Viral Hepat, 24(6): 486-495.

El?Akel W, El?Sayed M, El Kassas M, et al., 2017, National Treatment Programme of Hepatitis C in Egypt: Hepatitis C Virus Model of Care. J Viral Hepat, 24(4): 262-267.

Lazo M, Nwankwo C, Daya NR, et al., 2017, Confluence of Epidemics of Hepatitis C, Diabetes, Obesity, and Chronic Kidney Disease in the United States Population. Clin Gastroenterol Hepatol, 15(12): 1957-1964.

Kralj D, Jukic LV, Stojsavljevic S, et al., 2016, Hepatitis C Virus, Insulin Resistance, and Steatosis. J Clin Transl Hepatol, 4(1): 66.

Tsao Y-C, Chen J-Y, Yeh W-C, et al., 2017, Association Between Visceral Obesity and Hepatitis C Infection Stratified by Gender: A Cross-Sectional Study in Taiwan. BMJ Open, 7(11): e017117.

Leon L, Kasereka S, Barin F, et al., 2017, Infection, Age- and Time-Dependent Prevalence and Incidence of Hepatitis C Virus Infection in Drug Users in France, 2004-2011: Model-Based Estimation from Two National Cross-Sectional Serosurveys. Epidemiol Infect, 145(5): 895-907.

Cacoub P, Comarmond C, 2019, Considering Hepatitis C Virus Infection as a Systemic Disease. Seminars in Dialysis, 32(2): 99-107.

Desbois A-C, Cacoub P, 2017, Diabetes Mellitus, Insulin Resistance and Hepatitis C Virus Infection: A Contemporary Review. World J Gastroenterol, 23(9): 1697.

Chehadeh W, Abdella N, Ben?Nakhi A, et al., 2009, Risk Factors for the Development of Diabetes Mellitus in Chronic Hepatitis C Virus Genotype 4 Infection. J Gastroenterol Hepatol, 24(1): 42-48.

Hammerstad SS, Grock SF, Lee HJ, et al., 2015, Diabetes and Hepatitis C: A Two-Way Association. Front Endocrinol, 6: 134.

Kassem A, Salah HE, 2018, Impact of Direct Acting Antivirals for Treatment of Chronic Hepatitic C Virus Infection on Glycemic Control in Egyptian Patients with Type 2 Diabetes Mellitus. Life Science Journal, 15(3): 1-10.

Hum J, Jou JH, Green PK, et al., 2017, Improvement in Glycemic Control of Type 2 Diabetes After Successful Treatment of Hepatitis C Virus. Diabetes Care, 40(9): 1173-1180.

Dyal HK, Aguilar M, Bhuket T, et al., 2015, Concurrent Obesity, Diabetes, and Steatosis Increase Risk of Advanced Fibrosis Among HCV Patients: A Systematic Review. Dig Dis Sci, 60(9): 2813-2824.

Baecker A, Liu X, La CV, et al., 2018, Worldwide Incidence of Hepatocellular Carcinoma Cases Attributable to Major Risk Factors. Eur J Cancer Prev, 27(3): 205-212.

Ali-Eldin ZA, Ali-Eldin FA, Mohamed IE, 2017, Visceral Adiposity Index and the Degree of Hepatic Fibrosis and Inflammation in Egyptian Patients with Chronic Hepatitis C. J Clin Diagn Res, 11(8): OC11-OC14.

Gadallah M, Kandil S, Mohsen AJ, 2018, Association Between Hepatitis C Infection and Cerebro?Cardiovascular Disease: Analysis of a National Population?Based Survey in Egypt. Trop Med Int Health, 23(7): 738-747.

Petta S, Maida M, Macaluso FS, et al., 2016, Hepatitis C Virus Infection Is Associated with Increased Cardiovascular Mortality: A Meta-Analysis of Observational Studies. Gastroenterology, 150(1): 145-155.

Butt AA, Yan P, Shuaib A, et al., 2019, Direct-Acting Antiviral Therapy for HCV Infection Is Associated with a Reduced Risk of Cardiovascular Disease Events. Gastroenterology, 156(4): 987-996.

Osibogun O, Ogunmoroti O, Michos ED, et al., 2017, HIV/HCV Coinfection and the Risk of Cardiovascular Disease: A Meta?Analysis. J Viral Hepat, 24(11): 998-1004.

Fernandez?Montero J, Barreiro P, De Mendoza C, Pet al., 2016, Hepatitis C Virus Coinfection Independently Increases the Risk of Cardiovascular Disease in HIV?Positive Patients. J Viral Hepat, 23(1): 47-52.

Leone S, Prosperi M, Costarelli S, et al., 2016, Diseases, Incidence and Predictors of Cardiovascular Disease, Chronic Kidney Disease, and Diabetes in HIV/HCV-Coinfected Patients Who Achieved Sustained Virological Response. Eur J Clin Microbiol Infect Dis, 35(9): 1511-1520.