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

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

In: Clinical Infectious Diseases, 2007, vol. 45, no. 1, p. 111-119

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    Title
    • Factors Associated with the Incidence of Type 2 Diabetes Mellitus in HIV-Infected Participants in the Swiss HIV Cohort Study
    Author
    • Ledergerber, Bruno. Divisions of Infectious Diseases and Hospital Epidemiology, Zurich
    • Furrer, Hansjakob. Division of Infectious Diseases, University Hospital Berne, Berne
    • Rickenbach, Martin. Data Centre, Swiss HIV Cohort Study, Lausanne
    • Lehmann, Roger. Endocrinology and Diabetes, University Hospital, Zurich
    • Elzi, Luigia. Division of Infectious Diseases, University Hospital Basel, Basel
    • Hirschel, Bernard. Division of Infectious Diseases, University Hospital Geneva, Geneva
    • Cavassini, Matthias. Division of Infectious Diseases, University Hospital Lausanne, Lausanne
    • Bernasconi, Enos. Ospedale Regionale, Lugano
    • Schmid, Patrick. Division of Infectious Diseases, Cantonal Hospital, St. Gall, Switzerland
    • Egger, Matthias. Department of Social and Preventive Medicine, University of Berne, Berne
    • Weber, Rainer. Divisions of Infectious Diseases and Hospital Epidemiology, Zurich
    Document Type
    • Postprint
    Language
    • English
    Published in
    • Clinical Infectious Diseases, 2007, vol. 45, no. 1, p. 111-119. The University of Chicago Press
    Other Version
    Classification
    • Health
    OAI-PMH Identifier
    • oai:doc.rero.ch:290188
    Summary
    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