Increased risk of diabetes with HIV and HCV coinfection


Incidence and prevalence of diabetes mellitus was investigated in the large Italian ICONA cohort. For incidence, 6,505 participants were followed for a total of 38,062 years of follow-up. The incidence was compared in three groups: Hepatitis C antibody (HCV-ab) negative, HCV-ab positive with negative HCV-RNA and in the third group HCV-ab positive with positive HCVRNA. The relative risk of incident diabetes mellitus was increased in patients with HCV-ab+/HCV-RNA+ but not in HCV ab+/HCV-RNA-compared to those with negative HCV-ab. The adjusted relative risk was 1.73 (p=0.023). Other predictors significantly associated with increased risk of incidence diabetes were male sex, older age, higher BMI, higher baseline glucose, triglyceride levels and hypertension. Positive CMV serology had no impact. In the prevalence study 12,001 patients were included. Also in the prevalence study positivity for HCV-ab and HCV-RNA was associated with increased risk of diabetes mellitus but not in the group with positive antibodies and negative HCV-RNA. The adjusted odds ratio was 2.49 (p=0.032)

Luca et al. J Acquir Immune Defic Syndr 2017;75:465-471

Comment: Monoinfection with hepatitis C has been associated with increased likelihood of diabetes mellitus. In this study the association of active hepatitis C infection and risk of diabetes has been confirmed in HIV/HCV coinfected patients but not in HCV-ab positive but HCV-RNA negative patients. This is yet another argument to treat HCV as early as possible thus diminishing the risk of diabetes development.