Diabetes Risk Associated With Cirrhosis, Not Chronic HCV Infection, in HIV+ Patients

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Cirrhosis is associated with an increased risk for diabetes mellitus among patients living with HIV.
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.

Reference

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

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