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Reuters Health Information (2003-08-28): HIV/HCV coinfection and protease inhibitor treatment increase hyperglycemia risk


HIV/HCV coinfection and protease inhibitor treatment increase hyperglycemia risk

Last Updated: 2003-08-28 16:19:21 -0400 (Reuters Health)

NEW YORK (Reuters Health) - The combination of HIV and hepatitis C virus (HCV) coinfection with protease inhibitor (PI) treatment increases the risk of developing hyperglycemia, according to a report in the August 15th issue of JAIDS, the Journal of Acquired Immune Deficiency Syndromes.

HIV-1 protease inhibitors and HCV infection have each been independently associated with the development of hyperglycemia and other metabolic abnormalities, the authors explain, but the role of HCV coinfection in the development of diabetes and hyperglycemia among PI-treated patients remains uncertain.

Dr. Shruti H. Mehta and associates from Johns Hopkins University in Baltimore, Maryland, examined the prevalence and incidence of hyperglycemia among 1230 HIV-infected patients (47% HCV-negative and 53% HCV-positive) receiving highly active antiretroviral therapy (HAART) by HCV infection and type of HAART regimen.

New-onset hyperglycemia developed in 4.2% of the HAART recipients, the authors report, an incidence of 3.5 cases per 100 person-years. More than three-quarters of these individuals were also diagnosed with diabetes.

The incidence of new-onset hyperglycemia was more than twice as high among HCV-coinfected patients (5.8%, or 4.9 cases per 100 person-years) as among HCV-uninfected patients (2.8%, or 2.3 cases per 100 person-years), the report indicates.

HCV coinfection and PI use appeared to have an additive effect on the development of hyperglycemia, the results indicate, but there was no evidence of a multiplicative or synergistic effect of HCV coinfection and PI use.

The prevalence of hyperglycemia was also significantly higher among persons with HCV coinfection (5.9%) than among HCV-uninfected individuals (3.3%), the researchers note, but hyperglycemia prevalence did not differ for patients prescribed a PI and those not prescribed a PI.

"While our data support the association of hyperglycemia with HCV coinfection and PI use," the investigators write, "the etiopathogenesis of hyperglycemia among HIV-infected adults is unknown."

"Additional prospective studies are needed to better understand the pathogenesis of hyperglycemia among HIV-infected patients receiving HAART," the authors conclude, "particularly those coinfected with hepatitis C without previously described risk factors such as obesity."

J Acquir Immun Defic Syndr 2003;33:577-584.

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