Hepatitis C virus antibody‐positive patients with HIV infection have a high risk of insulin resistance: a cross‐sectional study

Objective The aim of the study was to characterize and compare insulin resistance (IR) in hepatitis C virus (HCV)‐antibody (Ab)‐positive and HCV‐Ab‐negative patients with HIV infection. Methods This was a single‐centre cross‐sectional study of 1041 HIV‐infected patients (373 HCV‐Ab‐positive; 167 with detectable plasma HCV RNA). Metabolic and anthropometric assessments were performed, including measurement of IR using the homeostasis model for assessment of insulin resistance (HOMA‐IR). Results The prevalence of IR (i.e. a HOMA‐IR score ≥3.8) was significantly higher in HCV‐Ab‐positive than in HCV‐Ab‐negative patients (47.7 vs. 32.7%; P <0.0001). On multivariable linear regression analysis, the following variables were associated with HOMA‐IR score, expressed as an estimate of the percentage variation (Est.): high‐density lipoprotein cholesterol (per 0.3 mmol/L increase: Est.–4.1; P =0.01), triglycerides (per 0.1 mmol/L increase: Est. 0.6; P <0.001), alcohol intake (Est. −12.4; P =0.002), sedentary lifestyle (Est. 14.7; P <0.001), CD4 T‐cell count in the highest quartile, i.e. ≥690 cells/μL (Est. 20.7; P =0.002), body mass index in the highest quartiles, i.e. ≥22.54 kg/m 2 (Est. 30.5–44.7; P <0.001), waist‐to‐hip ratio in the highest quartile, i.e. >1 (Est. 30.2; P <0.001) and HCV‐Ab positivity (Est. 24.4; P <0.001). Conclusions Our data confirm that HCV‐Ab positivity is an independent risk factor for IR. Management aimed at correcting known risk factors for IR should be implemented.