The effect of HAART and HCV infection on the development of hyperglycemia among HIV-infected persons.
OBJECTIVE
To examine the prevalence and incidence of hyperglycemia among HIV-infected patients by hepatitis C virus (HCV) infection and type of highly active antiretroviral therapy (HAART). DESIGN Retrospective cohort analysis of 1230 persons on their first HAART regimen who had at least 1 random glucose measurement before and during antiretroviral therapy.


METHODS
The prevalence of hyperglycemia and the incidence of hyperglycemia were compared among persons with and without HCV infection while on a protease inhibitor (PI)-containing HAART regimen, a nonnucleoside reverse transcriptase inhibitor (NNRTI)-containing regimen, or a regimen that contained both a PI and an NNRTI. Hyperglycemia was defined as either 2 random glucose levels > 11.1 mM (200 mg/dL) or documentation of the diagnosis of diabetes in the medical record.


RESULTS
The prevalence of hyperglycemia was significantly higher in HCV-coinfected (5.9%) than HCV-uninfected persons (3.3%, P = 0.02). Among persons receiving HAART, both HCV coinfection (adjusted relative hazard [ARH], 2.28; 95% CI, 1.23-4.22) and PI use (ARH, 5.02; 95% CI, 1.39-18.16) were independent risk factors of developing hyperglycemia. The incidence of hyperglycemia was highest among HCV-coinfected persons receiving a PI (5.6 cases per 100-person years) and only 1 person who was neither HCV-infected nor receiving a PI developed hyperglycemia.


CONCLUSIONS
In this urban HIV cohort, the risk of hyperglycemia was increased in HCV-coinfected patients and those prescribed a PI.
Mehta
Shruti H
SH
Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland 21287, USA.
Moore
Richard D
RD
Thomas
David L
DL
Chaisson
Richard E
RE
Sulkowski
Mark S
MS
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015142:Baltimore / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D017320:HIV Protease Inhibitors / Q000009:adverse effects; D006526:Hepatitis C / Q000150:complications*; D006785:Hospitals, University; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000209:etiology*; D015994:Incidence; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects; D012307:Risk Factors; D014505:Urban Population
D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors