Active HCV Replication but Not HCV or CMV Seropositive Status Is Associated with Incident and Prevalent Type 2 Diabetes in Persons Living with HIV

Andrea De Luca, Patrizia Lorenzini, Antonella Castagna, Massimo Puoti, Nicola Gianotti, Francesco Castelli, Claudio Mastroianni, Franco Maggiolo, Andrea Antinori, Giovanni Guaraldi, Miriam Lichtner, M. Galli, G. Ippolito, A. Lazzarin, C. F. Perno, E. Girardi, A. Ammassari, A. Calcagno, M. R. Capobianchi, P. CinqueE. Girardi, A. Gori, S. Nozza, M. M. Santoro, M. Zaccarelli, L. Galli, A. Rodano, F. Carletti, S. Carrara, A. Di Caro, S. Graziano, G. Prota, S. Quartu, S. Truffa, V. Donati, C. Viscoli, A. P. Castelli, M. Galli, A. Lazzarin, A. Gori, G. Magnani, A. Cristaudo, S. Cicalini, E. Nicastri, R. Acinapura, M. Capozzi, R. Libertone, A. Latini, M. S. Mura, M. Sciandra, the ICONA Foundation Study

Research output: Contribution to journalArticlepeer-review


Objective: To analyze the association between chronic hepatitis C virus (HCV) and cytomegalovirus (CMV) infections with type 2 diabetes in HIV-infected patients. Methods: HIV-1-infected patients enrolled in ICONA, a prospective cohort study involving 42 tertiary care centers in Italy, were selected with the following characteristics: for the diabetes incidence analysis, all patients with available CMV IgG results (first available test = baseline) and without type 2 diabetes were followed until onset of type 2 diabetes, last available clinical follow-up, death or September 30, 2014, whichever occurred first; for the prevalence analysis, all ICONA patients were analyzed at their last follow-up visit. Main outcome measures were the new onset of type 2 diabetes (incidence analysis) and the prevalence of type 2 diabetes at last follow-up. Results: During 38,062 person-years of follow-up (PYFU) in 6505 individuals, we observed 140 cases of incident type 2 diabetes (Incidence rate 3.7, 95% CI: 3.1 to 4.3, per 1000 PYFU). In a multivariable Poisson regression model, HCV-antibody (Ab)+/HCV RNA+ patients [adjusted relative rate versus HCV-Ab negative 1.73 (95% CI: 1.08 to 2.78)] but not HCV Ab+RNA- or CMV IgG+ patients, had a higher risk of diabetes. Among 12,001 patients, 306 (2.5%) prevalent cases of type 2 diabetes were detected. HCV Ab+RNA+ status was independently associated with prevalent diabetes (adjusted Odds Ratio vs HCV Ab- 2.49; 95% CI: 1.08 to 5.74), whereas HCV-Ab+/HCV RNA- and CMV IgG+ status were not. Conclusion: In HIV-infected individuals, active HCV replication but not prior HCV exposure or latent CMV infection is associated with incident and prevalent type 2 diabetes.

Original languageEnglish
Pages (from-to)465-471
Number of pages7
JournalJournal of Acquired Immune Deficiency Syndromes
Issue number4
Publication statusPublished - Aug 1 2017


  • CMV
  • diabetes
  • HCV
  • HIV-1

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)


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