Risk of type 2 diabetes mellitus after treatment with direct-acting antivirals for Hepatitis C virus in people with HIV.

Objective To compare the 3-year risk of type 2 diabetes mellitus (T2DM) in people with HIV-HCV after direct-acting antiviral (DAA) initiation and in people with HIV mono-infection.Design An observational study of two collaborations of cohorts from Europe and North America.Methods We matched individuals with evidence of ongoing HIV-HCV co-infection eligible to receive DAA (HepCAUSAL Collaboration) with individuals with HIV mono-infection (HIV-CAUSAL Collaboration) on cohort, calendar month, and probability of HCV diagnosis. We estimated the 3-year post-DAA T2DM risk had all HIV-HCV co-infection individuals initiated DAA using inverse probability weighting and compared it with the risk people with HIV mono-infection in subgroups defined by number of diabetes risk factors (0, 1-2, or ≥3).Results 34,135 people with HIV-HCV co-infection and 68,720 with HIV mono-infection were included. The difference in 3-year risk of T2DM for people with HIV-HCV after DAA and people with HIV mono-infection was 0.8% (95% confidence interval: -0.6, 5.8) in the subgroup with no risk factor, -0.4% (-1.5, 1.2) in the subgroup with 1-2 risk factors, and -1.7% (-4.7, 1.5) in the subgroup with ≥3 risk factors.Conclusions The estimated post-DAA risk of T2DM in people was similar to the risk in people with HIV mono-infection, though estimates were imprecise. These results suggest diabetes monitoring and prevention strategies should be the same for people with HIV who received DAA for HCV treatment as for people with HIV mono-infection, and based on risk factors.