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Influence of Hepatitis C Coinfection and Treatment on Risk of Diabetes Mellitus in HIV-Positive Persons

Authors :
Gerd Fätkenheuer
Montserrat Laguno
Dzmitry Paduta
Gilles Wandeler
Lars Peters
Cristiana Oprea
Simon G. Edwards
Hila Elinav
EuroSIDA study
Josep M. Llibre
Karine Lacombe
Jean-Paul Viard
Martin Gisinger
Amanda Mocroft
Irina Khromova
Inka Aho
Juergen K. Rockstroh
Jens D Lundgren
Błażej Rozpłochowski
Leo Flamholc
Lars N Nielsen
Giovanni Guaraldi
David Jilich
HUS Internal Medicine and Rehabilitation
Helsinki University Hospital Area
Source :
Open Forum Infectious Diseases, Mocroft, Amanda; Lundgren, Jens D; Rockstroh, Juergen K; Aho, Inka; Wandeler, Gilles; Nielsen, Lars; Edwards, Simon; Viard, Jean-Paul; Lacombe, Karine; Fätkenheuer, Gerd; Guaraldi, Giovanni; Laguno, Montserrat; Llibre, Josep; Elinav, Hila; Flamholc, Leo; Gisinger, Martin; Paduta, Dzmitry; Khromova, Irina; Jilich, David; Rozplochowski, Blazej; ... (2020). Influence of Hepatitis C Coinfection and Treatment on Risk of Diabetes Mellitus in HIV-Positive Persons. Open Forum Infectious Diseases, 7(12), ofaa470. Oxford University Press 10.1093/ofid/ofaa470 , Mocroft, A, Lundgren, J D, Rockstroh, J K, Aho, I, Wandeler, G, Nielsen, L, Edwards, S, Viard, J P, Lacombe, K, Fätkenheuer, G, Guaraldi, G, Laguno, M, Llibre, J, Elinav, H, Flamholc, L, Gisinger, M, Paduta, D, Khromova, I, Jilich, D, Rozplochowski, B, Oprea, C & Peters, L 2020, ' Influence of Hepatitis C Coinfection and Treatment on Risk of Diabetes Mellitus in HIV-Positive Persons ', Open Forum Infectious Diseases, vol. 7, no. 12, pp. 1-10 . https://doi.org/10.1093/ofid/ofaa470, r-IGTP. Repositorio Institucional de Producción Científica del Instituto de Investigación Germans Trias i Pujol, instname, Mocroft, A, Lundgren, J D, Rockstroh, J K, Aho, I, Wandeler, G, Nielsen, L, Edwards, S, Viard, J P, Lacombe, K, Fätkenheuer, G, Guaraldi, G, Laguno, M, Llibre, J, Elinav, H, Flamholc, L, Gisinger, M, Paduta, D, Khromova, I, Jilich, D, Rozplochowski, B, Oprea, C, Peters, L, EuroSIDA Study & Rasmussen, L D 2020, ' Influence of Hepatitis C Coinfection and Treatment on Risk of Diabetes Mellitus in HIV-Positive Persons ', Open Forum Infectious Diseases, vol. 7, no. 12, pp. 1-10 . https://doi.org/10.1093/ofid/ofaa470
Publication Year :
2020
Publisher :
Oxford University Press, 2020.

Abstract

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-RNA-positive 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.<br />Cirrhosis, but not HCV coinfection per se was associated with increased incidence of diabetes in a European cohort of >16000 PLWH. The biggest modifiable risk factors for diabetes were hypertension and obesity. Management of comorbidities in PLWH should be prioritised.

Details

Language :
English
ISSN :
23288957
Volume :
7
Issue :
12
Database :
OpenAIRE
Journal :
Open Forum Infectious Diseases
Accession number :
edsair.doi.dedup.....4bef6b02d5244b25d546709444ef5ad4
Full Text :
https://doi.org/10.1093/ofid/ofaa470