The effects of opiate use and hepatitis c virus infection on risk of diabetes mellitus in the women's interagency HIV study

Document Type

Journal Article

Publication Date

6-1-2010

Journal

Journal of Acquired Immune Deficiency Syndromes

Volume

54

Issue

2

DOI

10.1097/QAI.0b013e3181d0c911

Keywords

Diabetes mellitus; Fasting glucose; Hepatitis C virus; HIV; Opiate use; Women

Abstract

BACKGROUND: Opiate use is common in HIV-infected and hepatitis C virus (HCV)-infected individuals, however, its contribution to the risk of diabetes mellitus is not well understood. METHODS: Prospective study of 1713 HIV-infected and 652 HIV-uninfected participants from the Women's Interagency HIV Study between October 2000 and March 2006. Diabetes defined as fasting glucose ≥126 mg/dL, self report of diabetes medication use, or confirmed diabetes diagnosis. Opiate use determined using an interviewer-administered questionnaire. Detectable plasma HCV RNA confirmed HCV infection. RESULTS: Current opiate users had a higher prevalence of diabetes (15%) than nonusers (10%, P = 0.03), and a higher risk of incident diabetes (adjusted relative hazard: 1.58, 95% confidence interval: 1.01 to 2.46), after controlling for HCV infection, HIV/antiretroviral therapy status, and diabetes risk factors including age, race/ethnicity, family history of diabetes, and body mass index. HCV infection was also an independent risk factor for diabetes (adjusted relative hazard: 1.61, 95% confidence interval: 1.02 to 2.52). HCV-infected women reporting current opiate use had the highest diabetes incidence (4.83 cases per 100 person-years). CONCLUSIONS: Among women with or at-risk for HIV, opiate use is associated with increased diabetes risk independently of HCV infection. Diabetic screening should be part of care for opiate users and those infected with HCV. © 2010 Lippincott Williams & Wilkins.

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