836 Hepatitis C Increases the Risk of DM in HIV-infected Veterans in Care A. A. Butt*1,2,3, A. C. Justice1,2,3, S. L. Fultz1,2,3 1Univ of Pittsburgh, PA; 2VA Pittsburgh Hlthcare Sys, PA; and 3Ctr for Hlth Equity Res and Promotion, Pittsburgh, PA
Background: Human immunodeficiency virus (HIV) infection and the highly active antiretroviral therapy (HAART) used to treat HIV have been associated with various metabolic abnormalities including insulin resistance, glucose intolerance and diabetes mellitus (DM). Hepatitis C virus (HCV) infection has also been associated with a higher risk of developing DM. Hence it is plausible that patients (pts) co-infected with HCV and HIV, especially those on HAART, would have a higher risk of DM than those with HCV alone. We undertook this study to find out if pts with HCV-HIV co-infection have a higher risk of being diagnosed with DM than those with HCV infection alone.
Methods: Pts with an ICD-9 diagnosis of HIV were identified from the VA administrative database from 1989 onwards. Data on age, gender, race, history of and first date of HIV, HCV and DM diagnoses, and history of alcohol use was extracted from the VA administrative database. The disease data was based on ICD-9 codes. The ICD-9 codes for HIV and HCV have been validated in the Veterans Aging Cohort Study (VACS)
Results: A total of 41,262 veterans in care with HIV infection were identified. Of these, 14.8% had a diagnosis of DM and 17.9% had a diagnosis of HCV. The prevalence of DM in HCV infected pts was 19.7% compared with 13.7% (chi square = 167; p < 0.001) in the HCV negative pts. In a logistic regression model, the unadjusted odds ratio of having a DM diagnosis in HCV infected pts was 1.3 (95% CI 1.23-1.37). After controlling for age, race, history of drug and alcohol use, the adjusted odds ratio was 1.69 (95% CI 1.57-1.81). Adjustment was not made for 2 important predictors of DM in general population, body mass index and family history, because of lack of data.
Conclusions: HCV infection increases the risk of DM in HIV-infected veterans in care, which persists after adjusting for age, race, alcohol and drug use. Pts with HCV-HIV co-infection should be regularly screened for DM.
