Abstract

Background

The role of hepatitis C virus (HCV) coinfection and HCV-RNA in the development of diabetes mellitus (DM) in HIV-positive persons remains unclear.

Methods

Poisson regression was used to compare incidence rates of DM (blood glucose >11.1 mmol/L, HbA1C >6.5% or >48 mmol/mol, starting antidiabetic medicine or physician reported date of DM onset) between current HIV/HCV groups (anti-HCV-negative, spontaneously cleared HCV, chronic untreated HCV, successfully treated HCV, HCV-RNA-positive after HCV treatment).

Results

A total of 16 099 persons were included; at baseline 10 091 (62.7%) were HCV-Ab-negative, 722 (4.5%) were spontaneous clearers, 3614 (22.4%) were chronically infected, 912 (5.7%) had been successfully treated, and 760 (4.7%) were HCV-RNA-positive after treatment. During 136 084 person-years of follow-up (PYFU; median [interquartile range], 6.9 [3.6–13.2]), 1108 (6.9%) developed DM (crude incidence rate, 8.1/1000 PYFU; 95% CI, 7.7–8.6). After adjustment, there was no difference between the 5 HCV strata in incidence of DM (global P = .33). Hypertension (22.2%; 95% CI, 17.5%–26.2%) and body mass index >25 (22.0%; 95% CI, 10.4%–29.7%) had the largest population-attributable fractions for DM.

Conclusions

HCV coinfection and HCV cure were not associated with DM in this large study. The biggest modifiable risk factors were hypertension and obesity, and continued efforts to manage such comorbidities should be prioritized.

Details

Title
Influence of Hepatitis C Coinfection and Treatment on Risk of Diabetes Mellitus in HIV-Positive Persons
Author
Mocroft, Amanda 1   VIAFID ORCID Logo  ; Lundgren, Jens D 2 ; Rockstroh, Juergen K 3 ; Aho, Inka 4 ; Wandeler, Gilles 5 ; Nielsen, Lars 6 ; Edwards, Simon 7 ; Viard, Jean-Paul 8 ; Lacombe, Karine 9 ; Fätkenheuer, Gerd 10 ; Guaraldi, Giovanni 11   VIAFID ORCID Logo  ; Laguno, Montserrat 12 ; Llibre, Josep 13 ; Elinav, Hila 14 ; Flamholc, Leo 15 ; Gisinger, Martin 16 ; Paduta, Dzmitry 17 ; Khromova, Irina 18 ; Jilich, David 19 ; Rozplochowski, Blazej 20 ; Oprea, Cristiana 21 ; Peters, Lars 1 ; Harxhi, A; Losso, M; Kundro, M; Schmied, B; Zangerle, R; Karpov, I; Vassilenko, A; Paduto, D; Clumeck, N; De Wit, S; Delforge, M; Florence, E; Vandekerckhove, L; Hadziosmanovic, V; Begovac, J; Machala, L; Jilich, D; Sedlacek, D; Kronborg, G; Benfield, T; Gerstoft, J; Katzenstein, T; Pedersen, C; Johansen, I S; Ostergaard, L; Wiese, L; Moller, N F; Zilmer, K; Aho, I; J-P Viard; P-M Girard; Pradier, C; Fontas, E; Duvivier, C; Rockstroh, J; Behrens, G; Degen, O; Stellbrink, H J; Bogner, J; Fätkenheuer, G; Chkhartishvili, N; Sambatakou, H; Adamis, G; Paissios, N; Szlávik, J; Gottfredsson, M; Kelly, C; Tau, L; Turner, D; Burke, M; Shahar, E; Hassoun, G; Elinav, H; Haouzi, M; Elbirt, D; A D’arminio Monforte; Esposito, R; Mazeu, I; Mussini, C; Mazzotta, F; Gabbuti, A; Lazzarin, A; Castagna, A; Gianotti, N; Galli, M; Ridolfo, A; Uzdaviniene, V; Matulionyte, R; Staub, T; Hemmer, R; Dragas, S; Stevanovic, M; Reiss, P; Trajanovska, J; Reikvam, D H; Maeland, A; Bruun, J; Knysz, B; Gasiorowski, J; Inglot, M; Bakowska, E; Flisiak, R; Grzeszczuk, A; Parczewski, M; Maciejewska, K; Aksak-Was, B; Beniowski, M; Mularska, E; Jablonowska, E; Kamerys, J; Wojcik, K; Mozer-Lisewska, I; Rozplochowski, B; Zagalo, A; Mansinho, K; Maltez, F; Oprea, C; Yakovlev, A; Khromova, I; Kuzovatova, E; Borodulina, E; Vdoushkina, E; Ranin, J; Tomazic, J; Miro, J M; Laguno, M; Martinez, E; Garcia, F; Blanco, J L; Martinez-Rebollar, M; Mallolas, J; Callau, P; Rojas, J; Inciarta, A; Moreno, S; Clotet, B; Jou, A; Paredes, R; Puig, J; Llibre, J M; Santos, J R; Domingo, P; Gutierrez, M; Mateo, G; Sambeat, M A; Laporte, J M; Falconer, K; Thalme, A; Sonnerborg, A; Treutiger, C J; Flamholc, L; Scherrer, A; Weber, R; Cavassini, M; Calmy, A; Furrer, H; Battegay, M; Schmid, P; Kuznetsova, A; Mikhalik, J; Sluzhynska, M; Milinkovic, A; Johnson, A M; Simons, E; Edwards, S; Phillips, A; Johnson, M A; Mocroft, A; Winston, A; Clarke, A; Leen, C; Lundgren, J; Rasmussen, L D; Svedhem, V; Wandeler, G; Kowalska, J D; Miró, J M; Guaraldi, G; Kirk, O; Peters, L; Bojesen, A; Raben, D; Hansen, E V; Kristensen, D; Larsen, J F; Fischer, A H; Cozzi-Lepri, A; Amele, S; Pelchen-Matthews, A; Roen, A

1  Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, University College London, London, UK 
2  CHIP, Rigshospitalet, Copenhagen, Denmark 
3  University Hospital Bonn, Bonn, Germany 
4  Helsinki University Hospital, Helsinki, Finland 
5  Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland 
6  Nordsjællands Hospital, Hillerød, Denmark 
7  Mortimer Market Centre, London, UK 
8  Hôtel-Dieu, AP-HP, Paris, France 
9  Sorbonne Université, IPLESP Inserm UMR-S1136, AP-HP, Paris, France 
10  University Hospital of Cologne, Cologne, Germany 
11  University of Modena and Reggio Emilia, Modena, Italy 
12  Hospital Clinic, Barcelona, Spain 
13  University Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain 
14  Hadassah Hospital, Jerusalem, Israel 
15  Skane University Hospital, Malmö, Sweden 
16  Medical University of Innsbruck, Innsbruck, Austria 
17  Gomel Regional Centre for Hygiene, Gomel, Belarus 
18  Centre for HIV/AIDS & Infectious Diseases, Kaliningrad, Russia 
19  Charles University in Prague and Na Bulovce Hospital, Prague, Czech Republic 
20  Poznan University of Medical Sciences, Poznan, Poland 
21  Carol Davila University of Medicine and Pharmacy, Bucharest, Romania 
Publication year
2020
Publication date
Dec 2020
Publisher
Oxford University Press
e-ISSN
23288957
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1093/ofid/ofaa470
ProQuest document ID
3170946975
Copyright
© The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.