Impact of diabetes on the risk of serious liver events and liver-related deaths in people living with HIV and hepatitis C co-infection : data from the ICONA Foundation Cohort Study
Articolo
Data di Pubblicazione:
2019
Citazione:
Impact of diabetes on the risk of serious liver events and liver-related deaths in people living with HIV and hepatitis C co-infection : data from the ICONA Foundation Cohort Study / S. Leone, P. Lorenzini, A. Cozzi-Lepri, G. Orofino, D. Bernacchia, A. Castagna, M. Menozzi, G. Guaraldi, G. Madeddu, A. Di Biagio, M. Puoti, A. Gori, A. d'Arminio Monforte. - In: EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES. - ISSN 0934-9723. - 38:10(2019 Oct), pp. 1857-1865. [10.1007/s10096-019-03618-8]
Abstract:
To investigate the association between diabetes and HCV infection in persons living with HIV and to determine the impact of diabetes on the occurrence of serious liver events (SLEs) and liver-related deaths (LRDs) among HIV/HCV-co-infected patients. Patients were included if they had at least one follow-up visit. In a cross-sectional analysis among all HIV patients, we have investigated the association between diabetes and HCV infection. A further longitudinal analysis was performed in the population of HIV/HCV-co-infected free from SLE with FIB-4 index < 3.25 at baseline, using the following endpoints: (A) first event between SLE and LRD; (B) liver fibrosis progression defined as the first of two consecutive FIB-4 > 3.25; (C) first event between SLE, LRD, and liver fibrosis progression. Data from 15,571 HIV patients were analyzed: 2944 (18.9%) were HCV-Ab positive, and 739 (4.7%) presented a diagnosis of diabetes at their last follow-up. Among HIV/HCV-co-infected population, 107 patients had a diagnosis of diabetes. Viremic HCV-co-infected patients had 3-fold risk of diabetes onset than HCV-uninfected patients. On HIV/HCV-co-infected population, 85 SLEs/LRDs occurred over 20,410 person-years of follow-up (PYFU), for an incidence rate of 4.2/1000 PYFU (95%CI 3.4–5.2). Diabetic patients had 3-fold risk of pooled SLE and LRD than patients without diabetes. Furthermore, viremic HCV infection was independently associated with a higher risk of SLE/LRD (aIRR 3.35 [95%CI 1.14–9.83]). In HIV-infected patients, viremic HCV co-infection is a strong predictor of diabetes. Among HIV/HCV-co-infected population, diabetic patients showed an increased risk of SLE/LRD compared with those without diabetes.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Diabetes mellitus; HIV/HCV co-infection; Liver-related deaths; Serious liver events
Elenco autori:
S. Leone, P. Lorenzini, A. Cozzi-Lepri, G. Orofino, D. Bernacchia, A. Castagna, M. Menozzi, G. Guaraldi, G. Madeddu, A. Di Biagio, M. Puoti, A. Gori, A. d'Arminio Monforte
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