Diabetes Risk Associated With Cirrhosis, Not Chronic HCV Infection, in HIV+ Patients
Cirrhosis is associated with an increased risk for diabetes mellitus among patients living with HIV.
In people living with HIV, cirrhosis but not chronic hepatitis C virus (HCV) infection is associated with an increased risk for diabetes mellitus (DM), according to a large, multicenter study published in Alimentary Pharmacology & Therapeutics.
Researchers in France prospectively followed 28,699 people living with HIV for a mean duration of 12.4±7.9 years. Of these patients, 969 (3.4%) developed DM within a mean period of 11.0±6.4 years, yielding a rate ratio of DM of 2.74 cases per 1000 person-years of follow-up.
Four thousand four patients were coinfected with chronic HCV infection, and among these patients, 164 (4.1%) developed DM, which was a significantly higher rate than HIV monoinfected patients (4.1% vs 3.2%, P <.007). Older age, elevated body mass index, AIDS status, a nadir CD4 cell count ≤200/mm3, detectable HIV viral load, and cirrhosis were associated with the development of DM, but chronic HCV and hepatitis B virus infection were not.
Although a history of interferon-based HCV therapy was not associated with the development of DM, a longer duration of treatment with combination antiretroviral therapy was associated with a lower risk for DM.
In a subanalysis restricted to patients coinfected with HIV/HCV, sustained virological response was not found to be related to the development of DM.
"In conclusion, our study shows that in [patients living with HIV], cirrhosis is associated with an increased risk of DM, but not chronic HCV infection or duration of HCV infection," stated the authors.
Provoost A, Dramé M, Cotte L, et al; Dat'AIDS study group. Risk of diabetes in HIV-infected patients is associated with cirrhosis but not with chronic HCV coinfection in a French nationwide HIV cohort [published online June 14, 2018]. Aliment Pharmacol Ther. 2018. doi: 10.1111/apt.14812