619   Risk of HAART-Induced Hyperglycemia in HIV/HCV-Coinfected Patients.

M. Hoffman-Terry*, K. Badillo, A. Wasylik, P. Ogilvie, T. Wasser, and E. O'Donnell.
Lehigh Valley Hosp., Allentown, PA.

Background:Chronic hepatitis C (HCV) infection is known to be associated with an increased risk of non-insulin-dependent diabetes mellitus. Highly active antiretroviral therapy (HAART) has been found to predispose patients (pts.) to many metabolic complications, including hyperglycemia. We sought to explore whether HCV co-infection increased the risk of developing hyperglycemia while on HAART.

Methods:A retrospective case-control study was performed with 40 HIV/HCV pts. (Group 1) being matched to 40 HIV pts. without HCV (Group 2). Patients were excluded if they had other risk factors for hyperglycemia. Patients were matched by sex, age within ten years, and by body mass index (BMI) with 3 categories used for matching purposes: <20 (wasted), 20—25 (normal), >25 (overweight). HAART regimens, absolute CD4 counts, HIV viral loads (bDNA), blood sugars, and serum alanine aminotransferase levels (ALT), were recorded at baseline and then every 3 months, with most pts. reaching 9 months of follow-up.

Results:32 men and 8 women were included in each cohort. Race differed slightly between groups, with more Hispanics in Group 1 and more Caucasians in Group 2. Mean age was 41.3 years in Group 1 versus 39.1 years in Group 2. BMI was equivalent by grouped t testing. 31 patients in Group 1 vs. 27 in Group 2 were on protease inhibitor (PI) regimens. At baseline, mean absolute CD4 was significantly lower in Group 1 (279 vs. 394 cells × 10⁶/L with p = 0.032), with blood sugar and ALT being significantly higher (93.4 vs. 86.1mg/dl with p = 0.046 and 85.4 vs. 40.2 U/L with p = < 0.001). HIV viral load did not differ significantly at baseline. These differences remained for 9 months of follow-up. 5 coinfected pts. in Group 1 developed hyperglycemia, while none in Group 2 did, which was significant by chi-square test (p = 0.021). 4 met the ADA criteria of diabetes mellitus, while the 5th had hyperglycemia with evidence of peripheral insulin resistance. All had BMIs over 25; 4 were on PI regimens, and 3 were male. All developed hyperglycemia within the first 6 months of therapy.

Conclusions:Significantly more patients coinfected with HCV developed hyperglycemia while on HAART. Cofactors such as HCV need further study as the puzzle of metabolic derangements associated with HAART continues to unfold.