Amanda Mocroft1, Jens D Lundgren2, Juergen K Rockstroh3, Inka Aho4, Gilles Wandeler5, Lars Nielsen6, Simon Edwards7, Jean-Paul Viard8, Karine Lacombe9, Gerd Fätkenheuer10, Giovanni Guaraldi11, Montserrat Laguno12, Josep Llibre13, Hila Elinav14, Leo Flamholc15, Martin Gisinger16, Dzmitry Paduta17, Irina Khromova18, David Jilich19, Blazej Rozplochowski20, Cristiana Oprea21, Lars Peters1. 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.
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.
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.
Authors: Adeel A Butt; Wang Xiaoqiang; Matthew Budoff; David Leaf; Lewis H Kuller; Amy C Justice Journal: Clin Infect Dis Date: 2009-07-15 Impact factor: 9.079
Authors: Amanda Mocroft; Jens Lundgren; Jan Gerstoft; Line D Rasmussen; Sanjay Bhagani; Inka Aho; Christian Pradier; Johannes R Bogner; Christina Mussini; Caterina Uberti Foppa; Fernando Maltez; Montse Laguno; Gilles Wandeler; Karolin Falconer; Tatyana Trofimova; Elena Borodulina; Djordje Jevtovic; Elzbieta Bakowska; Kerstin Kase; Galina Kyselyova; Richard Haubrich; Jürgen K Rockstroh; Lars Peters Journal: Clin Infect Dis Date: 2020-05-06 Impact factor: 9.079