Factors Associated with the Incidence of Type 2 Diabetes Mellitus in HIV-Infected Participants in the Swiss HIV Cohort Study

• Published in: Clinical infectious diseases Vol. 45; no. 1; pp. 111 - 119
• Main Authors: Ledergerber, Bruno, Furrer, Hansjakob, Rickenbach, Martin, Lehmann, Roger, Elzi, Luigia, Hirschel, Bernard, Cavassini, Matthias, Bernasconi, Enos, Schmid, Patrick, Egger, Matthias, Weber, Rainer
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.07.2007; University of Chicago Press; Oxford University Press
• Subjects: Adult; AIDS; Anti-HIV Agents - therapeutic use; Antiretroviral Therapy, Highly Active; Antiretrovirals; Antivirals; Biological and medical sciences; Cohort Studies; Diabetes; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - etiology; Diabetes. Impaired glucose tolerance; Effects; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Ethnicity; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Hepatitis B virus; Hepatitis C virus; HIV; HIV Infections - complications; HIV Infections - drug therapy; HIV/AIDS; Human immunodeficiency virus; Human immunodeficiency virus 2; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Incidence; Infections; Infectious diseases; Male; Medical sciences; Medical treatment; Middle Aged; Preventive medicine; Risk Factors; Switzerland - epidemiology; Type 2 diabetes mellitus; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Switzerland; Endocrinopathy; Type 2 diabetes; Immunopathology; Retroviridae; Metabolic diseases; AIDS; Epidemiology; Immune deficiency; Lentivirus; Incidence; Infection; Virus; Viral disease; Cohort study; Human immunodeficiency virus
• ISSN: 1058-4838; 1537-6591; 1537-6591
• DOI: 10.1086/518619

Background. Human immunodeficiency virus (HIV)–infected persons may be at increased risk for developing type 2 diabetes mellitus because of viral coinfection and adverse effects of treatment. Methods. We studied associations of new-onset diabetes mellitus with hepatitis B virus and hepatitis C virus coinfections and antiretroviral therapy in participants in the Swiss HIV Cohort Study, using Poisson regression. Results. A total of 123 of 6513 persons experienced diabetes mellitus during 27,798 person-years of follow-up (PYFU), resulting in an incidence of 4.4 cases per 1000 PYFU (95% confidence interval [CI], 3.7–5.3 cases per 1000 PYFU). An increased incidence rate ratio (IRR) was found for male subjects (IRR, 2.5; 95% CI, 1.5–4.2), older age (IRR for subjects >60 years old, 4.3; 95% CI, 2.3–8.2), black (IRR, 2.1; 95% CI, 1.1–4.0) and Asian (IRR, 4.9; 95% CI, 2.2–10.9) ethnicity, Centers for Disease Control and Prevention disease stage C (IRR, 1.6; 95% CI, 1.04–2.4), and obesity (IRR, 4.7; 95% CI, 3.1–7.0), but results for hepatitis C virus infection or active hepatitis B virus infection were inconclusive. Strong associations were found for current treatment with nucleoside reverse-transcriptase inhibitors (IRR, 2.22; 95% CI, 1.11–4.45), nucleoside reverse-transcriptase inhibitors plus protease inhibitors (IRR, 2.48; 95% CI, 1.42–4.31), and nucleoside reverse-transcriptase inhibitors plus protease inhibitors and nonnucleoside reverse-transcriptase inhibitors (IRR, 3.25; 95% CI, 1.59–6.67) but were not found for treatment with nucleoside reverse-transcriptase inhibitors plus nonnucleoside reverse-transcriptase inhibitors (IRR, 1.47; 95% CI, 0.77–2.82). Conclusions. In addition to traditional risk factors, current treatment with protease inhibitor– and nucleoside reverse-transcriptase inhibitor–containing regimens was associated with the risk of developing type 2 diabetes mellitus. Our study did not find a significant association between viral hepatitis infection and risk of incident diabetes.