Understanding Genetic Risk for Diabetes in People Living with HIV: What It Means for the Community
Type 2 diabetes (T2D) is one of the most common health problems affecting people living with HIV (PWH). Research has shown that PWH are more likely to develop T2D than those without HIV, and scientists have been trying to understand why. A recent study led by Marco Labarile sheds new light on this issue by looking at the role of genetics—specifically, polygenic risk scores (PRS)—in predicting diabetes risk among PWH.
PRS are scores based on many small genetic variations that, when combined, can estimate a person’s inherited risk for certain diseases, such as T2D. This study used two such scores: one for T2D and another for body mass index (BMI), a known diabetes risk factor. By analyzing data from nearly 700 individuals with diabetes and over 2’400 matched controls in the Swiss HIV Cohort Study (SHCS), the researchers found that higher genetic risk scores were str ongly linked with the likelihood of developing T2D—even after accounting for age, BMI, and HIV treatment.
Importantly, they discovered that certain HIV medications, particularly integrase inhibitors (INSTIs) and protease inhibitors (PIs), were also associated with increased diabetes risk. However, one major HIV-related factor—CD4-cell count—did not appear to influence diabetes development. This suggests that while managing HIV remains essential, additional attention should be paid to the metabolic effects of HIV treatment.
This work highlights the critical role of the SHCS in advancing our understanding of long-term health issues in PWH. Thanks to its comprehensive and ongoing data collection from over half of all diagnosed HIV cases in Switzerland, the SHCS enabled researchers to explore the interplay between genetics, treatment, and health outcomes in this unique population.
For PWH and their healthcare providers, this study underscores the importance of personalized care. As tools like PRS become more accessible, they could help identify individuals at higher risk of diabetes earlier—potentially leading to better prevention strategies and tailored treatment decisions. It’s one more step toward ensuring longer, healthier lives for people living with HIV.