Poor glycemic control in type-2 diabetic patients infected with hepatitis B: A retrospective propensity-matched study

Hepatitis B virus (HBV) infection and type-2 diabetes mellitus (T2DM) affect millions of individuals worldwide, whereas their interplay remains largely unclear. Here, we analyzed a large cohort of 330 HBV-infected inpatients with T2DM (so-called HBV + T2DM patients) and 330 T2DM inpatients without HBV infection (T2DM patients). Poor glycemic control was defined by glycated hemoglobin (HbA1c) >= 7%. Among 330 HBV + T2DM patients, 252 (76%) aged >= 50 years, 223 (68%) were males, 205 (62%) experienced poor glycemic control. The propensity-score matching approach was applied to match patient age, gender, comorbidities, and antidiabetic treatment between T2DM + HBV and T2DM patients. Compared with T2DM patients, HBV + T2DM patients had poorer glycemic control, longer hospitalization length, and higher alanine aminotransferase (p < 0.05). HBV + T2DM patients with HBV DNA >= 100 IU/mL or HBsAg >= 0.05 IU/mL had worse HbA1c control than T2DM patients without HBV infection (p < 0.05). HBV + T2DM patients who received no anti-HBV therapy had worse HbA1c control than HBV + T2DM patients receiving anti-HBV therapy (p < 0.05). Both insulin and anti-HBV therapy were significant factors associated with glycemic control in HBV + T2DM patients. Overall, HBV + T2DM patients exhibited poorer glycemic control than T2DM patients, but their clinical outcomes were likely improved by insulin plus anti-HBV treatment. Early management of HBV infection likely contributes to better clinical outcomes in HBV-infected patients with T2DM.

Automated summary

HBV infection leads to poor glycemic control in patients with T2DM, and the association between HBV infection and T2DM treatment is still unclear. In this study, analysis of 330 hospitalized patients with HBV infection and T2DM showed that HBV infection is associated with poor glycemic control, longer hospitalization, and abnormal liver function. Moreover, higher HBV infection levels are associated with worse glycemic control, while receiving anti-HBV therapy and insulin treatment are significant factors for glycemic control. Early management of HBV infection may contribute to better clinical outcomes in patients with HBV infection and T2DM.