TY - JOUR
T1 - Influence of Hepatitis C Coinfection and Treatment on Risk of Diabetes Mellitus in HIV-Positive Persons
AU - Mocroft, Amanda
AU - Lundgren, Jens D.
AU - Rockstroh, Juergen K.
AU - Aho, Inka
AU - Wandeler, Gilles
AU - Nielsen, Lars
AU - Edwards, Simon
AU - Viard, Jean Paul
AU - Lacombe, Karine
AU - Fätkenheuer, Gerd
AU - Guaraldi, Giovanni
AU - Laguno, Montserrat
AU - Llibre, Josep
AU - Elinav, Hila
AU - Flamholc, Leo
AU - Gisinger, Martin
AU - Paduta, Dzmitry
AU - Khromova, Irina
AU - Jilich, David
AU - Rozplochowski, Blazej
AU - Oprea, Cristiana
AU - Peters, Lars
AU - EuroSIDA Study
A2 - Rasmussen, Line Dahlerup
N1 - Publisher Copyright:
© 2020 Oxford University Press. All rights reserved.
PY - 2020/12/1
Y1 - 2020/12/1
N2 - 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-RNApositive 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.
AB - 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-RNApositive 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.
KW - Diabetes mellitus
KW - Direct-acting antivirals
KW - Hepatitis c
KW - HIV
KW - Sustained virologic response
U2 - 10.1093/ofid/ofaa470
DO - 10.1093/ofid/ofaa470
M3 - Journal article
C2 - 33409325
AN - SCOPUS:85100339858
VL - 7
SP - 1
EP - 10
JO - Open Forum Infectious Diseases
JF - Open Forum Infectious Diseases
SN - 2328-8957
IS - 12
ER -