The effects of opiate use and hepatitis C virus infection on risk of diabetes mellitus in the Women's Interagency HIV Study.
BACKGROUND
Opiate use is common in HIV-infected and hepatitis C virus (HCV)-infected individuals, however, its contribution to the risk of diabetes mellitus is not well understood.


METHODS
Prospective study of 1713 HIV-infected and 652 HIV-uninfected participants from the Women's Interagency HIV Study between October 2000 and March 2006. Diabetes defined as fasting glucose > or =126 mg/dL, self report of diabetes medication use, or confirmed diabetes diagnosis. Opiate use determined using an interviewer-administered questionnaire. Detectable plasma HCV RNA confirmed HCV infection.


RESULTS
Current opiate users had a higher prevalence of diabetes (15%) than nonusers (10%, P = 0.03), and a higher risk of incident diabetes (adjusted relative hazard: 1.58, 95% confidence interval: 1.01 to 2.46), after controlling for HCV infection, HIV/antiretroviral therapy status, and diabetes risk factors including age, race/ethnicity, family history of diabetes, and body mass index. HCV infection was also an independent risk factor for diabetes (adjusted relative hazard: 1.61, 95% confidence interval: 1.02 to 2.52). HCV-infected women reporting current opiate use had the highest diabetes incidence (4.83 cases per 100 person-years).


CONCLUSIONS
Among women with or at-risk for HIV, opiate use is associated with increased diabetes risk independently of HCV infection. Diabetic screening should be part of care for opiate users and those infected with HCV.
Howard
Andrea A
AA
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA. aah2138@columbia.edu
Hoover
Donald R
DR
Anastos
Kathryn
K
Wu
Xi
X
Shi
Qiuhu
Q
Strickler
Howard D
HD
Cole
Stephen R
SR
Cohen
Mardge H
MH
Kovacs
Andrea
A
Augenbraun
Michael
M
Latham
Patricia S
PS
Tien
Phyllis C
PC
D000328:Adult; D000367:Age Factors; D000701:Analgesics, Opioid / Q000009:adverse effects*; D001786:Blood Glucose / Q000032:analysis; D016001:Confidence Intervals; D003920:Diabetes Mellitus / Q000209:etiology* / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008875:Middle Aged; D016017:Odds Ratio; D009293:Opioid-Related Disorders / Q000150:complications*; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors
D000701:Analgesics, Opioid; D001786:Blood Glucose