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Predictors of insulin resistance among Hispanic adults infected with or at risk of infection with the human immunodeficiency virus and hepatitis C virus
Author(s) -
CastanedaSceppa C.,
Bermudez O. I.,
Wanke C.,
Forrester J. E.
Publication year - 2008
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/j.1365-2893.2008.01021.x
Subject(s) - medicine , hepatitis c virus , insulin resistance , nucleoside , human immunodeficiency virus (hiv) , hepatitis c , virology , protease inhibitor (pharmacology) , reverse transcriptase inhibitor , gastroenterology , immunology , virus , insulin , biology , sida , viral disease , viral load , antiretroviral therapy , biochemistry
Summary. Both the human immunodeficiency (HIV) and hepatitis C (HCV) viruses have been associated with insulin resistance (IR). However, our understanding of the prevalence of IR, the underlying mechanisms and predisposing factors is limited, particularly among minority populations. We conducted a study of 333 Hispanic adults including: 76 HIV monoinfected, 62 HCV monoinfected, 97 HIV/HCV co‐infected and 98 uninfected controls with a specific focus on HCV infection and liver injury as possible predictors of IR. IR was measured using the Quantitative Insulin Sensitivity Check Index (QUICKI). The majority (55–69%) of participants in all groups had QUICKI values <0.350. Body mass index was associated with IR in all groups. Triglycerides were associated with IR in the uninfected control group only (−1.83, SE = 0.58, P = 0.0022). HCV was associated with IR in participants infected with HIV (−0.012, SE = 0.0046, P = 0.010). Liver injury, as measured by score to assess liver injury (FIB‐4) score, was significantly associated with IR independently of HCV infection (−0.0035, SE = 0.0016, P = 0.027). In the HIV/HCV co‐infected group, treatment with nucleoside reverse‐transcriptase (RT) inhibitors plus non‐nucleoside RT inhibitors (−0.021, SE = 0.080, P = 0.048), but not protease inhibitors (−0.000042, SE = 0.0082, P = 0.96) was associated with IR. HCV infection and antiretroviral agents, including nucleoside RT inhibitor plus non‐nucleoside RT inhibitor treatment are contributors to IR in HIV infection. Liver injury, as measured by the FIB‐4 score, is a predictor of IR independently of HCV infection.