Hepatitis C virus antibody-positive patients with HIV infection have a high risk of insulin resistance: a cross-sectional study.
OBJECTIVE
The aim of the study was to characterize and compare insulin resistance (IR) in hepatitis C virus (HCV)-antibody (Ab)-positive and HCV-Ab-negative patients with HIV infection.


METHODS
This was a single-centre cross-sectional study of 1041 HIV-infected patients (373 HCV-Ab-positive; 167 with detectable plasma HCV RNA). Metabolic and anthropometric assessments were performed, including measurement of IR using the homeostasis model for assessment of insulin resistance (HOMA-IR).


RESULTS
The prevalence of IR (i.e. a HOMA-IR score >or=3.8) was significantly higher in HCV-Ab-positive than in HCV-Ab-negative patients (47.7 vs. 32.7%; P<0.0001). On multivariable linear regression analysis, the following variables were associated with HOMA-IR score, expressed as an estimate of the percentage variation (Est.): high-density lipoprotein cholesterol (per 0.3 mmol/L increase: Est.-4.1; P=0.01), triglycerides (per 0.1 mmol/L increase: Est. 0.6; P<0.001), alcohol intake (Est. -12.4; P=0.002), sedentary lifestyle (Est. 14.7; P<0.001), CD4 T-cell count in the highest quartile, i.e. >or=690 cells/microL (Est. 20.7; P=0.002), body mass index in the highest quartiles, i.e. >or=22.54 kg/m2 (Est. 30.5-44.7; P<0.001), waist-to-hip ratio in the highest quartile, i.e. >1 (Est. 30.2; P<0.001) and HCV-Ab positivity (Est. 24.4; P<0.001).


CONCLUSIONS
Our data confirm that HCV-Ab positivity is an independent risk factor for IR. Management aimed at correcting known risk factors for IR should be implemented.
Squillace
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N
Department of Medicine and Medical Specialties, Infectious Diseases Clinic, University of Modena and Reggio Emilia, Modena, Italy. nicosqui@inwind.it
Lapadula
G
G
Torti
C
C
Orlando
G
G
Mandalia
S
S
Nardini
G
G
Beghetto
B
B
Costarelli
S
S
Guaraldi
G
G
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D018937:Hepatitis C Antibodies / Q000097:blood*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000276:immunology; D006801:Humans; D007333:Insulin Resistance / Q000276:immunology*; D008297:Male; D012307:Risk Factors
D018937:Hepatitis C Antibodies