Factors associated with the incidence of type 2 diabetes mellitus in HIV-infected participants in the swiss HIV cohort study

Background. Human immunodeficiency virus ( HIV)-infected persons may be at increased risk for developing type 2 diabetes mellitus because of viral coinfection and adverse effects of treatment. Methods. We studied associations of new-onset diabetes mellitus with hepatitis B virus and hepatitis C virus coinfections and antiretroviral therapy in participants in the Swiss HIV Cohort Study, using Poisson regression. Results. A total of 123 of 6513 persons experienced diabetes mellitus during 27,798 person-years of follow-up ( PYFU), resulting in an incidence of 4.4 cases per 1000 PYFU ( 95% confidence interval [ CI], 3.7-5.3 cases per 1000 PYFU). An increased incidence rate ratio ( IRR) was found for male subjects ( IRR, 2.5; 95% CI, 1.5-4.2), older age ( IRR for subjects 160 years old, 4.3; 95% CI, 2.3-8.2), black ( IRR, 2.1; 95% CI, 1.1-4.0) and Asian ( IRR, 4.9; 95% CI, 2.2-10.9) ethnicity, Centers for Disease Control and Prevention disease stage C ( IRR, 1.6; 95% CI, 1.04-2.4), and obesity ( IRR, 4.7; 95% CI, 3.1-7.0), but results for hepatitis C virus infection or active hepatitis B virus infection were inconclusive. Strong associations were found for current treatment with nucleoside reverse-transcriptase inhibitors ( IRR, 2.22; 95% CI, 1.11-4.45), nucleoside reverse-transcriptase inhibitors plus protease inhibitors ( IRR, 2.48; 95% CI, 1.42-4.31), and nucleoside reverse-transcriptase inhibitors plus protease inhibitors and nonnucleoside reverse-transcriptase inhibitors ( IRR, 3.25; 95% CI, 1.59-6.67) but were not found for treatment with nucleoside reverse-transcriptase inhibitors plus nonnucleoside reverse-transcriptase inhibitors ( IRR, 1.47; 95% CI, 0.77-2.82). Conclusions. In addition to traditional risk factors, current treatment with protease inhibitor- and nucleoside reverse-transcriptase inhibitor-containing regimens was associated with the risk of developing type 2 diabetes mellitus. Our study did not find a significant association between viral hepatitis infection and risk of incident diabetes.