Risk of diabetes in HIV infected veterans pre- and Post-HAART and the role of HCV coinfection
Risk of diabetes in HIV infected veterans pre- and Post-HAART and the role of HCV coinfection
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DOI：
10.1002/hep.20289
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发表时间：
2004-07-01
期刊：
影响因子：
13.5
通讯作者：
Justice, AC
中科院分区：
文献类型：
--
作者：
Butt, AA;Fultz, SL;Justice, AC
我们研究了丙型肝炎病毒（HCV）感染与糖尿病的退伍军人感染人类免疫缺陷病毒（HIV）之前和之后的机构的高效抗逆转录病毒治疗（HAART）。年龄，种族，肝病，酒精和药物诊断对糖尿病风险的作用也被确定。从退伍军人事务部（VA）行政数据库中确定了1992年至2001年期间进入护理的男性艾滋病毒退伍军人。提取人口统计学和疾病数据。绘制Kaplan-Meier曲线以确定糖尿病的发病率。使用考克斯回归方法确定未校正和校正的糖尿病风险比。共有26，988名退伍军人接受了研究。在多变量考克斯回归分析中，与糖尿病诊断相关的因素包括年龄增加（HR，每10岁增加1.44; 95% CI，1.39-1.49），少数民族（非裔美国人：HR，1.35; 95% CI，1.24-1.48;西班牙裔：HR，1.63; 95% CI，1.43-1.86），以及HAART时代的护理（HR，2.35; 95% CI，2.01-2.75）。HAART时期的护理与HCV感染之间存在显著的相互作用，在HAART时期HCV感染与糖尿病的显著风险相关（HR，1.39; 95%CI，1.27-1-53），但在HAART前时期则无关（HR，1.01; 95%CI，0.75-1.36）。总之，与HAART前相比，HAART时代的HIV感染退伍军人患糖尿病的风险更高。HCV合并感染与HAART时期糖尿病风险显著升高相关，但与HAART前时期无关。HCV/HIV合并感染的患者应积极筛查糖尿病。
We examined the association of hepatitis C virus (HCV) infection with diabetes in veterans infected with human immunodeficiency virus (HIV) before and after the institution of highly active antiretroviral therapy (HAART). The role of age, race, liver disease, alcohol, and drug diagnoses upon the risk of diabetes was also determined. Male veterans with HIV who entered care between 1992 and 2001 were identified from the Veterans Affairs (VA) administrative database. Demographic and disease data were extracted. Kaplan-Meier curves were plotted to determine the incidence of diabetes. Unadjusted and adjusted hazards ratios for diabetes were determined using Cox regression method. A total of 26,988 veterans were studied. In multivariate Cox regression analysis, factors associated with a diagnosis of diabetes included increasing age (HR, 1.44 per 10-year increase in age; 95% CI, 1.39-1.49), minority race (African American: HR, 1.35; 95% Cl, 1.24-1.48; Hispanic: HR, 1.63; 95% Cl, 1.43-1.86), and care in the HAART era (HR, 2.35; 95% CI, 2.01-2.75). There was a significant interaction between care in the HAART era and HCV infection, with HCV infection being associated with a significant risk of diabetes in the HAART era (HR, 1.39; 95% Cl, 1.27-1-53) but not in the pre-HAART era (HR, 1.01; 95% CI, 0.75-1.36). In conclusion, HIV-infected veterans in the HAART era are at a higher risk for diabetes compared with those in the pre-HAART era. HCV coinfection is associated with a significantly higher risk of diabetes in the HAART era, but not in the pre-HAART era. HCV HIV coinfected patients should be aggressively screened for diabetes.