Risk of Diabetes Mellitus in Persons with and without HIV: A Danish Nationwide Population-Based Cohort Study

In a nationwide, population-based cohort study we assessed the risk of diabetes mellitus (DM) in HIV-infected individuals compared with the general population, and evaluated the impact of risk factors for DM in HIV-infected individuals. We identified 4,984 Danish-born HIV-infected individuals from t...

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Veröffentlicht in:PloS one Jg. 7; H. 9; S. e44575
Hauptverfasser: Rasmussen, Line D., Mathiesen, Elisabeth R., Kronborg, Gitte, Pedersen, Court, Gerstoft, Jan, Obel, Niels
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Public Library of Science 12.09.2012
Public Library of Science (PLoS)
Schlagworte:
Acquired immune deficiency syndrome
Adult
AIDS
Anti-Retroviral Agents - therapeutic use
Antiretroviral agents
Antiretroviral drugs
Antiretroviral Therapy, Highly Active - methods
Biology
Body mass
Body Mass Index
Cohort analysis
Cohort Studies
Denmark
Development and progression
Diabetes Complications - diagnosis
Diabetes mellitus
Diabetes Mellitus - diagnosis
Didanosine
Didanosine - therapeutic use
Drugs
Exposure
Female
Health risks
Highly active antiretroviral therapy
HIV
HIV Infections - complications
HIV Infections - diagnosis
HIV Infections - therapy
Human immunodeficiency virus
Humans
Identification methods
Incidence
Indinavir
Indinavir - therapeutic use
Insulin resistance
Lipoatrophy
Male
Medical diagnosis
Medicine
Middle Aged
Poisson density functions
Population studies
Population-based studies
Regression Analysis
Risk analysis
Risk assessment
Risk Factors
Saquinavir
Saquinavir - therapeutic use
Statistical analysis
Stavudine
Stavudine - therapeutic use
Treatment Outcome
Denmark
United States > US
ISSN:1932-6203, 1932-6203
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Zusammenfassung:In a nationwide, population-based cohort study we assessed the risk of diabetes mellitus (DM) in HIV-infected individuals compared with the general population, and evaluated the impact of risk factors for DM in HIV-infected individuals. We identified 4,984 Danish-born HIV-infected individuals from the Danish HIV Cohort Study and a Danish born population-based age- and gender-matched comparison cohort of 19,936 individuals (study period: 1996-2009). Data on DM was obtained from the Danish National Hospital Registry and the Danish National Prescription Registry. Incidence rate ratios (IRR) and impact of risk factors including exposure to Highly Active Antiretroviral Therapy (HAART) and antiretroviral drugs were estimated by Poisson regression analyses. In the period 1996-1999 risk of DM was higher in HIV-infected individuals compared to the comparison cohort (adjusted IRR: 2.83; 95%CI: 1.57-5.09), both before (adjusted IRR: 2.40; 95%CI: 1.03-5.62) and after HAART initiation (adjusted IRR: 3.24; 95% CI: 1.42-7.39). In the period 1999-2010 the risk of DM in HIV-infected individuals did not differ from that of the comparison cohort (adjusted IRR: 0.90; 95% CI: 0.72-1.13), although the risk was decreased before HAART-initiation (adjusted IRR: 0.45; 95%CI: 0.21-0.96). Increasing age, BMI and the presence of lipoatrophy increased the risk of DM, as did exposure to indinavir, saquinavir, stavudine and didanosine. Native HIV-infected individuals do not have an increased risk of developing DM compared to a native background population after year 1998. Some antiretroviral drugs, not used in modern antiretroviral treatment, seem to increase the risk of DM.
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Competing Interests: The authors read the journal's policy and declare the following potential conflicts of interest. N. Obel has received research funding from Roche, Bristol-Myers Squibb, Merck Sharp & Dohme, GlaxoSmithKline, Abbott, Boehringer Ingelheim, Janssen-Cilag and Swedish Orphan Drugs. C. Pedersen has received research funding from Abbott, Roche, Bristol-Myers Squibb, Merck Sharp & Dohme, GlaxoSmithKline, Swedish Orphan Drugs and Boehringer Ingelheim. J. Gerstoft has received research funding from Abbott, Roche, Bristol-Myers Squibb, Mecrk Sharp & Dohme, Pharmasia, GlaxoSmithKline, Swedish Orphan Drugs and Boehringer Ingelheim. E.R. Mathiesen, G. Kronborg and L.D. Rasmussen report no conflicts of interest. The potential conflicts of interest described above do not alter the authors' adherence to all the PLoS ONE policies on sharing data and materials.
Conceived and designed the analytical strategy: LDR ERM NO. Collected and assembled the data/patients: CP GK JG NO. Conducted the literature review: LDR ERM. Analyzed and interpreted the data: LDR GK CP JG NO. Statistical expertise: LDR NO. Wrote the manuscript: Drafting of the article: LDR. Revised the article critically for important intellectual content: LDR ERM GK CP JG NO. Performed the final approval of the article: LDR ERM GK CP JG NO. Obtained the funding: NO CP GK JG. Performed the administrative, technical, or logistic support: LDR NO.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0044575