Leukocyte count and new-onset diabetes mellitus in people with HIV: A longitudinal study

Sophia C Meyer; Zoe Klein; Isabella C Schoepf; Christian W Thorball; Marco Labarile; Neeltje A Kootstra; Peter Reiss; Lene Ryom; Dominique L Braun; Maria C Thurnheer; Catia Marzolini; Christian R Kahlert; Enos Bernasconi; Matthias Cavassini; Annalisa Marinosci; Jacques Fellay; Huldrych F Günthard; Roger D Kouyos; Bruno Ledergerber; Philip E Tarr; Swiss HIV Cohort Study

doi:10.1111/hiv.70089

Leukocyte count and new-onset diabetes mellitus in people with HIV: A longitudinal study

Sophia C Meyer, Zoe Klein, Isabella C Schoepf, Christian W Thorball, Marco Labarile, Neeltje A Kootstra, Peter Reiss, Lene Ryom, Dominique L Braun, Maria C Thurnheer, Catia Marzolini, Christian R Kahlert, Enos Bernasconi, Matthias Cavassini, Annalisa Marinosci, Jacques Fellay, Huldrych F Günthard, Roger D Kouyos, Bruno Ledergerber, Philip E Tarr^*Swiss HIV Cohort Study

^*Corresponding author for this work

1 Citation (Scopus)

Abstract

OBJECTIVES: The risk of diabetes mellitus (DM) is increased in people with HIV. Chronic inflammation contributes to DM risk. High leukocytes are associated with DM in the general population, but in people with HIV, evidence of a leukocyte-DM association is limited.

METHODS: We included participants of the Swiss HIV Cohort Study with new-onset DM (2000-2023) and matched controls. We obtained uni- and multivariable odds ratios (ORs) for DM, based on traditional and HIV-related DM risk factors, leukocyte count and potential confounders for leukocyte count.

RESULTS: Among 732 DM cases (median age 54 years, 79% male at birth, 86% with suppressed HIV RNA) and 2032 DM-free controls, the latest leukocyte count prior to DM diagnosis was higher in cases than in controls (median [interquartile range], 6200 [5115-7800] vs. 5900/μL [4800-7180]; p < 0.001), but leucocytosis (>11 000/μL) was uncommon (3.8% vs. 2.3%; p = 0.032). DM-OR in the highest vs. lowest leukocyte quintile was 1.91 (95% confidence interval, 1.45-2.52) in univariable analysis and 2.47 (1.71-3.57) in multivariable analysis. For comparison, multivariable DM-OR for dyslipidaemia, overweight, ≥12-month stavudine exposure and ≥12-month integrase inhibitor exposure were 2.23 (1.80-2.75), 2.83 (2.21-3.62), 1.54 (1.16-2.04) and 2.29 (1.13-4.62), respectively. We found no relevant confounders for the leukocyte-DM association. Leukocytes were significantly associated with DM up to 10 years before diagnosis (all p < 0.02).

CONCLUSIONS: High leukocyte count is an independent DM risk factor in people with HIV in Switzerland and increases the risk of DM to a degree similar to traditional and HIV-related risk factors, up to 10 years before DM diagnosis.

Original language	English
Journal	HIV Medicine
Volume	26
Issue number	10
Pages (from-to)	1585-1599
Number of pages	15
ISSN	1464-2662
DOIs	https://doi.org/10.1111/hiv.70089
Publication status	Published - Oct 2025

Keywords

Adult
Diabetes Mellitus/epidemiology
Female
HIV Infections/complications
Humans
Leukocyte Count
Longitudinal Studies
Male
Middle Aged
Risk Factors
Switzerland/epidemiology

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Meyer, S. C., Klein, Z., Schoepf, I. C., Thorball, C. W., Labarile, M., Kootstra, N. A., Reiss, P., Ryom, L., Braun, D. L., Thurnheer, M. C., Marzolini, C., Kahlert, C. R., Bernasconi, E., Cavassini, M., Marinosci, A., Fellay, J., Günthard, H. F., Kouyos, R. D., Ledergerber, B., ... Swiss HIV Cohort Study (2025). Leukocyte count and new-onset diabetes mellitus in people with HIV: A longitudinal study. HIV Medicine, 26(10), 1585-1599. https://doi.org/10.1111/hiv.70089

Meyer, SC, Klein, Z, Schoepf, IC, Thorball, CW, Labarile, M, Kootstra, NA, Reiss, P, Ryom, L, Braun, DL, Thurnheer, MC, Marzolini, C, Kahlert, CR, Bernasconi, E, Cavassini, M, Marinosci, A, Fellay, J, Günthard, HF, Kouyos, RD, Ledergerber, B, Tarr, PE & Swiss HIV Cohort Study 2025, 'Leukocyte count and new-onset diabetes mellitus in people with HIV: A longitudinal study', HIV Medicine, vol. 26, no. 10, pp. 1585-1599. https://doi.org/10.1111/hiv.70089

@article{a578b324bad24c61a51ea82632575823,

title = "Leukocyte count and new-onset diabetes mellitus in people with HIV: A longitudinal study",

abstract = "OBJECTIVES: The risk of diabetes mellitus (DM) is increased in people with HIV. Chronic inflammation contributes to DM risk. High leukocytes are associated with DM in the general population, but in people with HIV, evidence of a leukocyte-DM association is limited.METHODS: We included participants of the Swiss HIV Cohort Study with new-onset DM (2000-2023) and matched controls. We obtained uni- and multivariable odds ratios (ORs) for DM, based on traditional and HIV-related DM risk factors, leukocyte count and potential confounders for leukocyte count.RESULTS: Among 732 DM cases (median age 54 years, 79\% male at birth, 86\% with suppressed HIV RNA) and 2032 DM-free controls, the latest leukocyte count prior to DM diagnosis was higher in cases than in controls (median [interquartile range], 6200 [5115-7800] vs. 5900/μL [4800-7180]; p < 0.001), but leucocytosis (>11 000/μL) was uncommon (3.8\% vs. 2.3\%; p = 0.032). DM-OR in the highest vs. lowest leukocyte quintile was 1.91 (95\% confidence interval, 1.45-2.52) in univariable analysis and 2.47 (1.71-3.57) in multivariable analysis. For comparison, multivariable DM-OR for dyslipidaemia, overweight, ≥12-month stavudine exposure and ≥12-month integrase inhibitor exposure were 2.23 (1.80-2.75), 2.83 (2.21-3.62), 1.54 (1.16-2.04) and 2.29 (1.13-4.62), respectively. We found no relevant confounders for the leukocyte-DM association. Leukocytes were significantly associated with DM up to 10 years before diagnosis (all p < 0.02).CONCLUSIONS: High leukocyte count is an independent DM risk factor in people with HIV in Switzerland and increases the risk of DM to a degree similar to traditional and HIV-related risk factors, up to 10 years before DM diagnosis.",

keywords = "Adult, Diabetes Mellitus/epidemiology, Female, HIV Infections/complications, Humans, Leukocyte Count, Longitudinal Studies, Male, Middle Aged, Risk Factors, Switzerland/epidemiology",

author = "Meyer, \{Sophia C\} and Zoe Klein and Schoepf, \{Isabella C\} and Thorball, \{Christian W\} and Marco Labarile and Kootstra, \{Neeltje A\} and Peter Reiss and Lene Ryom and Braun, \{Dominique L\} and Thurnheer, \{Maria C\} and Catia Marzolini and Kahlert, \{Christian R\} and Enos Bernasconi and Matthias Cavassini and Annalisa Marinosci and Jacques Fellay and G{\"u}nthard, \{Huldrych F\} and Kouyos, \{Roger D\} and Bruno Ledergerber and Tarr, \{Philip E\} and \{Swiss HIV Cohort Study\}",

note = "{\textcopyright} 2025 The Author(s). HIV Medicine published by John Wiley \& Sons Ltd on behalf of British HIV Association.",

year = "2025",

month = oct,

doi = "10.1111/hiv.70089",

language = "English",

volume = "26",

pages = "1585--1599",

journal = "HIV Medicine",

issn = "1464-2662",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "10",

}

TY - JOUR

T1 - Leukocyte count and new-onset diabetes mellitus in people with HIV

T2 - A longitudinal study

AU - Meyer, Sophia C

AU - Klein, Zoe

AU - Schoepf, Isabella C

AU - Thorball, Christian W

AU - Labarile, Marco

AU - Kootstra, Neeltje A

AU - Reiss, Peter

AU - Ryom, Lene

AU - Braun, Dominique L

AU - Thurnheer, Maria C

AU - Marzolini, Catia

AU - Kahlert, Christian R

AU - Bernasconi, Enos

AU - Cavassini, Matthias

AU - Marinosci, Annalisa

AU - Fellay, Jacques

AU - Günthard, Huldrych F

AU - Kouyos, Roger D

AU - Ledergerber, Bruno

AU - Tarr, Philip E

AU - Swiss HIV Cohort Study

PY - 2025/10

Y1 - 2025/10

N2 - OBJECTIVES: The risk of diabetes mellitus (DM) is increased in people with HIV. Chronic inflammation contributes to DM risk. High leukocytes are associated with DM in the general population, but in people with HIV, evidence of a leukocyte-DM association is limited.METHODS: We included participants of the Swiss HIV Cohort Study with new-onset DM (2000-2023) and matched controls. We obtained uni- and multivariable odds ratios (ORs) for DM, based on traditional and HIV-related DM risk factors, leukocyte count and potential confounders for leukocyte count.RESULTS: Among 732 DM cases (median age 54 years, 79% male at birth, 86% with suppressed HIV RNA) and 2032 DM-free controls, the latest leukocyte count prior to DM diagnosis was higher in cases than in controls (median [interquartile range], 6200 [5115-7800] vs. 5900/μL [4800-7180]; p < 0.001), but leucocytosis (>11 000/μL) was uncommon (3.8% vs. 2.3%; p = 0.032). DM-OR in the highest vs. lowest leukocyte quintile was 1.91 (95% confidence interval, 1.45-2.52) in univariable analysis and 2.47 (1.71-3.57) in multivariable analysis. For comparison, multivariable DM-OR for dyslipidaemia, overweight, ≥12-month stavudine exposure and ≥12-month integrase inhibitor exposure were 2.23 (1.80-2.75), 2.83 (2.21-3.62), 1.54 (1.16-2.04) and 2.29 (1.13-4.62), respectively. We found no relevant confounders for the leukocyte-DM association. Leukocytes were significantly associated with DM up to 10 years before diagnosis (all p < 0.02).CONCLUSIONS: High leukocyte count is an independent DM risk factor in people with HIV in Switzerland and increases the risk of DM to a degree similar to traditional and HIV-related risk factors, up to 10 years before DM diagnosis.

AB - OBJECTIVES: The risk of diabetes mellitus (DM) is increased in people with HIV. Chronic inflammation contributes to DM risk. High leukocytes are associated with DM in the general population, but in people with HIV, evidence of a leukocyte-DM association is limited.METHODS: We included participants of the Swiss HIV Cohort Study with new-onset DM (2000-2023) and matched controls. We obtained uni- and multivariable odds ratios (ORs) for DM, based on traditional and HIV-related DM risk factors, leukocyte count and potential confounders for leukocyte count.RESULTS: Among 732 DM cases (median age 54 years, 79% male at birth, 86% with suppressed HIV RNA) and 2032 DM-free controls, the latest leukocyte count prior to DM diagnosis was higher in cases than in controls (median [interquartile range], 6200 [5115-7800] vs. 5900/μL [4800-7180]; p < 0.001), but leucocytosis (>11 000/μL) was uncommon (3.8% vs. 2.3%; p = 0.032). DM-OR in the highest vs. lowest leukocyte quintile was 1.91 (95% confidence interval, 1.45-2.52) in univariable analysis and 2.47 (1.71-3.57) in multivariable analysis. For comparison, multivariable DM-OR for dyslipidaemia, overweight, ≥12-month stavudine exposure and ≥12-month integrase inhibitor exposure were 2.23 (1.80-2.75), 2.83 (2.21-3.62), 1.54 (1.16-2.04) and 2.29 (1.13-4.62), respectively. We found no relevant confounders for the leukocyte-DM association. Leukocytes were significantly associated with DM up to 10 years before diagnosis (all p < 0.02).CONCLUSIONS: High leukocyte count is an independent DM risk factor in people with HIV in Switzerland and increases the risk of DM to a degree similar to traditional and HIV-related risk factors, up to 10 years before DM diagnosis.

KW - Adult

KW - Diabetes Mellitus/epidemiology

KW - Female

KW - HIV Infections/complications

KW - Humans

KW - Leukocyte Count

KW - Longitudinal Studies

KW - Male

KW - Middle Aged

KW - Risk Factors

KW - Switzerland/epidemiology

UR - https://www.scopus.com/pages/publications/105013757967

U2 - 10.1111/hiv.70089

DO - 10.1111/hiv.70089

M3 - Journal article

C2 - 40747677

SN - 1464-2662

VL - 26

SP - 1585

EP - 1599

JO - HIV Medicine

JF - HIV Medicine

IS - 10

ER -

Leukocyte count and new-onset diabetes mellitus in people with HIV: A longitudinal study

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