HCV coinfection associated with an increased risk of diabetes in HIV-positive US veterans

Michael Carter
Estimated reading time 2 minutes
This article is more than 21 years old.

Coinfection with hepatitis C virus (HCV) is associated with a significantly increased risk of an HIV-positive individual developing diabetes, according to a large American study presented to the 43rd Interscience Conference on Antimicrobial Agents and Chemotherapy which is taking place in Chicago between September 14 - 17th.

Investigators conducted a retrospective analysis of the medical records of 33,280 HIV-positive veterans and 38,232 veterans who were HCV-infected but HIV-negative controls who had received care since the introduction of HAART (October 1996 - September 2001). The purpose of their study was to establish if individuals coinfected with HIV and HCV were at increased risk of diabetes and if there were any other risk factors.

Demographic information was collected along with data on date of infection with HCV and HIV, drug and alcohol use, and the incidence of diabetes.

Glossary

diabetes

A group of diseases characterized by high levels of blood sugar (glucose). Type 1 diabetes occurs when the body fails to produce insulin, which is a hormone that regulates blood sugar. Type 2 diabetes occurs when the body either does not produce enough insulin or does not use insulin normally (insulin resistance). Common symptoms of diabetes include frequent urination, unusual thirst and extreme hunger. Some antiretroviral drugs may increase the risk of type 2 diabetes.

sample

Studies aim to give information that will be applicable to a large group of people (e.g. adults with diagnosed HIV in the UK). Because it is impractical to conduct a study with such a large group, only a sub-group (a sample) takes part in a study. This isn’t a problem as long as the characteristics of the sample are similar to those of the wider group (e.g. in terms of age, gender, CD4 count and years since diagnosis).

retrospective study

A type of longitudinal study in which information is collected on what has previously happened to people - for example, by reviewing their medical notes or by interviewing them about past events. 

chemotherapy

The use of drugs to treat an illness, especially cancer.

Univariate analysis of the entire sample suggested that infection with HCV, each ten year increase in age, and black or Hispanic race were associated with an increased risk of diabetes (all tested to P

In multivariate analysis the risk of diabetes was significantly higher in HIV-positive patients coinfected with HCV than in patients monoinfected with HCV (Hazard Ratio [HR] 1.64, 95% CI 1.51 - 1.78, versus 1.37, 95% CI, 1.26 - 1.50). What’s more, the association found with age (HR 1.64, 95% CI, 1.59 - 1.68), black (HR1.28, 95% CI, 1.18 - 1.37) and Hispanic race (HR1.35, 95% CI, 1.20 - 1.52) in univariate analysis, only remained significant for individuals with HIV.

Drug and alcohol use were not significantly associated with the risk of diabetes in HIV-positive patients (p>0.05), but remained so in HIV-negative patients (p

The investigators emphasised that their study did not record key data on certain diabetes risk-factors, including body mass index (BMI), and family history of diabetes. In addtion, data on the use of specific antiretroviral drugs were not recorded, and the investigators stressed that their study was only able to demonstrate an association between HCV and HIV coinfection and an increased risk of diabetes. The degree to which this risk is associated with the effects of HIV infection, or the long-term effects of HAART remains to be determined and warrants further study, say the researchers.

References

Butt AA et al. Understanding the association between DM and HIV and HCV infections in the era of HAART. 43rdICAAC, abstract H-1715, Chicago, September 14 - 17th, 2003.

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