BACKGROUND: The role of hepatitis C virus (HCV) coinfection and HCV-RNA in the development of diabetes mellitus (DM) in HIV-positive persons remains unclear. METHODS: Poisson regression was used to compare incidence rates of DM (blood glucose >11.1 mmol/L, HbA1C >6.5% or >48 mmol/mol, starting antidiabetic medicine or physician reported date of DM onset) between current HIV/HCV groups (anti-HCV-negative, spontaneously cleared HCV, chronic untreated HCV, successfully treated HCV, HCV-RNA-positive after HCV treatment). RESULTS: A total of 16 099 persons were included; at baseline 10 091 (62.7%) were HCV-Ab-negative, 722 (4.5%) were spontaneous clearers, 3614 (22.4%) were chronically infected, 912 (5.7%) had been successfully treated, and 760 (4.7%) were HCV-RNA-positive after treatment. During 136 084 person-years of follow-up (PYFU; median [interquartile range], 6.9 [3.6-13.2]), 1108 (6.9%) developed DM (crude incidence rate, 8.1/1000 PYFU; 95% CI, 7.7-8.6). After adjustment, there was no difference between the 5 HCV strata in incidence of DM (global P = .33). Hypertension (22.2%; 95% CI, 17.5%-26.2%) and body mass index >25 (22.0%; 95% CI, 10.4%-29.7%) had the largest population-attributable fractions for DM. CONCLUSIONS: HCV coinfection and HCV cure were not associated with DM in this large study. The biggest modifiable risk factors were hypertension and obesity, and continued efforts to manage such comorbidities should be prioritized.

Carol Davila University of Medicine and Pharmacy Bucharest Romania

Centre for Clinical Research Epidemiology Modelling and Evaluation Institute for Global Health University College London London UK

Centre for HIV AIDS and Infectious Diseases Kaliningrad Russia

Charles University Prague and Na Bulovce Hospital Prague Czech Republic

CHIP Rigshospitalet Copenhagen Denmark

Department of Infectious Diseases Bern University Hospital University of Bern Bern Switzerland

Gomel Regional Centre for Hygiene Gomel Belarus

Hadassah Hospital Jerusalem Israel

Helsinki University Hospital Helsinki Finland

Hospital Clinic Barcelona Spain

Hôtel Dieu AP HP Paris France

Medical University of Innsbruck Innsbruck Austria

Mortimer Market Centre London UK

Nordsjællands Hospital Hillerød Denmark

Poznan University of Medical Sciences Poznan Poland

Skane University Hospital Malmö Sweden

Sorbonne Université IPLESP Inserm UMR S1136 AP HP Paris France

University Hospital Bonn Bonn Germany

University Hospital Germans Trias i Pujol Badalona Barcelona Spain

University Hospital of Cologne Cologne Germany

University of Modena and Reggio Emilia Modena Italy

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