Altered fat distribution and chronic inflammation are found in both persons living with HIV (PLWH) and persons with diabetes mellitus type 2 (DM2) and are known risk factors for CVD. We aimed to investigate if a synergistic effect of HIV infection and DM2 was found on fat distribution and inflammation. Methods A cross-sectional study was performed including PLWH with HIV RNA <200 copies/mL (18 with DM2 (HIV + DM2+), 18 without DM2 (HIV + DM2-)) and uninfected persons (19 with DM2 (HIV-DM2+) and

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... 25 without DM2 (HIV-DM2-)). We measured fat distribution using dual-energy X-ray absorptiometry scan. Plasma concentrations of adiponectin, interleukin-6 (IL-6), tumor necrosis factor-alfa (TNF-α) and soluble CD14 (sCD14) was measured using snap-frozen plasma. Results HIV+DM2+ and HIV+DM2-had comparable trunk/limb fat ratio. In contrast, HIV+DM2+ had a higher trunk/ limb fat ratio than HIV-DM2+ and HIV-DM2-(p=0.013 and p<0.001, respectively). However, HIV+DM2+ and HIV-DM2+ had comparable amount of trunk fat mass (kg) (p=0.254). A lower concentration of plasma adiponectin and higher concentration of IL-6 was found in HIV+DM2+ than in HIV+DM2-(p=0.037 and p=0.039) and in HIV-DM2-(p=0.001 and p=0.012). In contrast, plasma adiponectin and IL-6 concentrations were comparable in HIV+DM2+ and HIV-DM2+ (p=0.345 and p=0.825). Concentration of sCD14 was comparable in HIV+DM2+ and HIV+DM2-(p=0.850), but elevated in HIV+DM2+ compared to HIV-DM2+ (p<0.001) and HIV-DM2-(p=0.007). No statistical interactions were found between HIV infection and DM2 for any of the depending variables. Conclusion A synergistic effect of HIV and DM2 was not found for any of the outcomes. However, HIV+DM2+ had features related to both HIV infection and DM2+ with a high trunk/limb ratio, high trunk fat mass, low concentration of plasma adiponectin and elevated concentrations of IL-6 and sCD14. This could contribute to