Risk of diabetes in HIV ‐infected patients is associated with cirrhosis but not with chronic HCV coinfection in a French nationwide HIV cohort

Summary Background Both human immunodeficiency virus ( HIV ) and hepatitis C virus ( HCV ) infections have been reportedly associated with a higher risk of diabetes mellitus ( DM ) but results are conflicting. Aims To determine whether there is an association between chronic HCV and the incidence of DM , and to study the role of factors such as cirrhosis, IFN ‐based HCV therapy, sustained virologic response ( SVR ) and chronic HBV infection among patients living with HIV ( PLHIV ) followed in a large French multicentre cohort in the combination antiretroviral therapy ( cART ) era. Methods All PLHIV followed up in the Dat’ AIDS cohort were eligible. Cox models for survival analysis were used to study the time to occurrence of DM . Results Among 28 699 PLHIV , 4004 patients had chronic HCV infection. The mean duration of HCV follow‐up was 12.5 ± 8.1 years. The rate ratio of DM was 2.74 per 1000 person‐years. By multivariate analysis, increasing age, body mass index>25, AIDS status, nadir CD 4 cell count ≤200/mm 3 , detectable HIV viral load and cirrhosis ( HR 2.26 95% CI 1.14‐1.18; P  < 0.0001) were predictors of DM , whereas longer cART duration was associated with a lower risk of DM . Chronic HCV and HBV infection and IFN ‐based HCV therapy were not associated with DM . In a subanalysis among HCV ‐infected patients, SVR was not related to DM . Conclusions Our study shows that in the HIV population, cirrhosis is associated with an increased occurrence of DM , but not chronic HCV infection or duration of HCV infection.