Hepatitis C virus antibody-positive patients with HIV infection have a high risk of insulin resistance: a cross-sectional study

Objective The aim of the study was to characterize and compare insulin resistance (IR) in hepatitis C virus (HCV)-antibody (Ab)-positive and HCV-Ab-negative patients with HIV infection. Methods This was a single-centre cross-sectional study of 1041 HIV-infected patients (373 HCV-Ab-positive; 167 with detectable plasma HCV RNA). Metabolic and anthropometric assessments were performed, including measurement of IR using the homeostasis model for assessment of insulin resistance (HOMA-IR). Results The prevalence of IR (i.e. a HOMA-IR score >= 3.8) was significantly higher in HCV-Ab-positive than in HCV-Ab-negative patients (47.7 vs. 32.7%; P < 0.0001). On multivariable linear regression analysis, the following variables were associated with HOMA-IR score, expressed as an estimate of the percentage variation (Est.): high-density lipoprotein cholesterol (per 0.3 mmol/L increase: Est.-4.1; P=0.01), triglycerides (per 0.1 mmol/L increase: Est. 0.6; P < 0.001), alcohol intake (Est. -12.4; P=0.002), sedentary lifestyle (Est. 14.7; P < 0.001), CD4 T-cell count in the highest quartile, i.e. >= 690 cells/mu L (Est. 20.7; P=0.002), body mass index in the highest quartiles, i.e. >= 22.54 kg/m(2) (Est. 30.5-44.7; P < 0.001), waist-to-hip ratio in the highest quartile, i.e. > 1 (Est. 30.2; P < 0.001) and HCV-Ab positivity (Est. 24.4; P < 0.001). Conclusions Our data confirm that HCV-Ab positivity is an independent risk factor for IR. Management aimed at correcting known risk factors for IR should be implemented.