Patients with HIV infection on most highly active antiretroviral therapy (HAART) regimens have an increased incidence of new-onset type 2 diabetes mellitus, the latest findings of the Swiss HIV Cohort Study show.
Principal investigator Dr. Rainer Weber of University Hospital Zurich and colleagues studied the association between new-onset type 2 diabetes mellitus and HAART with hepatitis B and hepatitis C viral co-infection in 6,513 individuals in the Swiss HIV Cohort Study. Follow-up covered 27,798 person-years.
The investigators found 123 cases of new-onset diabetes, or 4.4 cases per 1,000 person-years of follow-up.
When the researchers calculated incidence rate ratios (IRRs), male gender had an IRR of 2.5; age above 60 years had an IRR of 4.3; black ethnicity had an IRR of 2.1, Asian ethnicity had an IRR of 4.9, Centers for Disease Control and Prevention (CDC) HIV disease of stage C had an IRR of 1.6, and obesity had an IRR of 4.7.
IRRs for hepatitis B and C co-infection were "inconclusive."
"Strong associations" were found for new-onset type 2 diabetes and current treatment with nucleoside reverse-transcriptase inhibitors, with an IRR of 2.22, for nucleoside reverse transcriptase inhibitors plus protease inhibitors, with an IRR of 2.48 and for nucleoside reverse transcriptase inhibitors plus protease inhibitors plus nonnucleoside reverse-transcriptase inhibitors, with an IRR of 3.25.
No association was found for treatment with nucleoside reverse-transcriptase inhibitors plus nonnucleoside reverse-transcriptase inhibitors and new-onset type 2 diabetes.
"The substantial benefits of combination antiretroviral therapy continue to clearly outweigh the increased risk of diabetes mellitus type 2 induced by this therapy," Dr. Weber told Reuters Health.
"However, prevention of modifiable risk factors for diabetes mellitus type 2 and atherosclerosis is crucial in the care of HIV-infected persons," he said. "Modifiable risks for diabetes or cardiovascular disease include high caloric diet, overweight, lack of exercise, smoking, elevated blood lipids."
The latest findings of the Swiss HIV Cohort Study are published in the July 1st issue of HIV/AIDS Clinical Infectious Diseases.
Clinical Infectious Diseases 2007;45:111-119.
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