高效抗逆转录病毒治疗（HAART）和丙型肝炎病毒（HCV）感染对HIV感染者高血糖发生的影响。

The effect of HAART and HCV infection on the development of hyperglycemia among HIV-infected persons.

作者信息

Mehta Shruti H, Moore Richard D, Thomas David L, Chaisson Richard E, Sulkowski Mark S

机构信息

Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland 21287, USA.

出版信息

J Acquir Immune Defic Syndr. 2003 Aug 15;33(5):577-84. doi: 10.1097/00126334-200308150-00005.

DOI:10.1097/00126334-200308150-00005

PMID:12902801

Abstract

OBJECTIVE

To examine the prevalence and incidence of hyperglycemia among HIV-infected patients by hepatitis C virus (HCV) infection and type of highly active antiretroviral therapy (HAART). DESIGN Retrospective cohort analysis of 1230 persons on their first HAART regimen who had at least 1 random glucose measurement before and during antiretroviral therapy.

METHODS

The prevalence of hyperglycemia and the incidence of hyperglycemia were compared among persons with and without HCV infection while on a protease inhibitor (PI)-containing HAART regimen, a nonnucleoside reverse transcriptase inhibitor (NNRTI)-containing regimen, or a regimen that contained both a PI and an NNRTI. Hyperglycemia was defined as either 2 random glucose levels > 11.1 mM (200 mg/dL) or documentation of the diagnosis of diabetes in the medical record.

RESULTS

The prevalence of hyperglycemia was significantly higher in HCV-coinfected (5.9%) than HCV-uninfected persons (3.3%, P = 0.02). Among persons receiving HAART, both HCV coinfection (adjusted relative hazard [ARH], 2.28; 95% CI, 1.23-4.22) and PI use (ARH, 5.02; 95% CI, 1.39-18.16) were independent risk factors of developing hyperglycemia. The incidence of hyperglycemia was highest among HCV-coinfected persons receiving a PI (5.6 cases per 100-person years) and only 1 person who was neither HCV-infected nor receiving a PI developed hyperglycemia.

CONCLUSION

In this urban HIV cohort, the risk of hyperglycemia was increased in HCV-coinfected patients and those prescribed a PI.

摘要

目的

通过丙型肝炎病毒（HCV）感染情况及高效抗逆转录病毒治疗（HAART）类型，研究HIV感染患者高血糖的患病率和发病率。设计：对1230例接受首个HAART方案且在抗逆转录病毒治疗前及治疗期间至少进行过1次随机血糖检测的患者进行回顾性队列分析。

方法

比较接受含蛋白酶抑制剂（PI）的HAART方案、含非核苷类逆转录酶抑制剂（NNRTI）的方案或同时含PI和NNRTI方案的患者中，有无HCV感染时高血糖的患病率及发病率。高血糖定义为2次随机血糖水平>11.1 mM（200 mg/dL）或病历中有糖尿病诊断记录。

结果

HCV合并感染患者的高血糖患病率（5.9%）显著高于未感染HCV的患者（3.3%，P = 0.02）。在接受HAART的患者中，HCV合并感染（调整相对风险[ARH]，2.28；95%置信区间[CI]，1.23 - 4.22）和使用PI（ARH，5.02；95% CI，1.39 - 18.16）均为发生高血糖的独立危险因素。接受PI的HCV合并感染患者中高血糖发病率最高（每100人年5.6例），且未感染HCV且未接受PI治疗的患者中仅有1人发生高血糖。