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1 July 2007

Volume 45, Number 1
Clinical Infectious Diseases 2007;45:111–119
© 2007 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2007/4501-0021$15.00
DOI: 10.1086/518619
HIV/AIDS MAJOR ARTICLE

Factors Associated with the Incidence of Type 2 Diabetes Mellitus in HIV‐Infected Participants in the Swiss HIV Cohort Study

Bruno Ledergerber,1

Hansjakob Furrer,3

Martin Rickenbach,5

Roger Lehmann,2

Luigia Elzi,7

Bernard Hirschel,8

Matthias Cavassini,6

Enos Bernasconi,9

Patrick Schmid,10

Matthias Egger,4 and

Rainer Weber,1 and the

Swiss HIV Cohort Studya

Divisions of 1Infectious Diseases and Hospital Epidemiology and 2Endocrinology and Diabetes, University Hospital, Zurich, 3Division of Infectious Diseases, University Hospital Berne, and 4Department of Social and Preventive Medicine, University of Berne, Berne, 5Data Centre, Swiss HIV Cohort Study, and 6Division of Infectious Diseases, University Hospital Lausanne, Lausanne, 7Division of Infectious Diseases, University Hospital Basel, Basel, 8Division of Infectious Diseases, University Hospital Geneva, Geneva, 9Ospedale Regionale, Lugano, and 10Division of Infectious Diseases, Cantonal Hospital, St. Gall, Switzerland

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 >60 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.

Received 18 December 2006; accepted 22 March 2007; electronically published 21 May 2007.

Reprints or correspondence: Dr. Bruno Ledergerber, Div. of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Ramistrasse 100, CH‐8091 Zurich, Switzerland ().

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  • Members of the Swiss HIV Cohort Study are listed at the end of the text.

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