Journal Article

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

Bruno Ledergerber, Hansjakob Furrer, Martin Rickenbach, Roger Lehmann, Luigia Elzi, Bernard Hirschel, Matthias Cavassini, Enos Bernasconi, Patrick Schmid, Matthias Egger and Rainer Weber

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 45, issue 1, pages 111-119
Published in print July 2007 | ISSN: 1058-4838
Published online July 2007 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/518619
Factors Associated with the Incidence of Type 2 Diabetes Mellitus in HIV-Infected Participants in the Swiss HIV Cohort Study

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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.

Journal Article.  4874 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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