Age, Exposure to Antiretrovirals Affect Diabetes Risk in HIV

Patients with HIV who are older and have a longer duration of exposure to antiretroviral medications have a significantly increased risk for type 2 diabetes, according to results published online in PLoS One.

The results of this study highlight the need for effective diabetes prevention and management strategies that target conventional and HIV-specific risk factors.

The study included people who were HIV positive from 3 London outpatient clinics, and data were collected during 2 time periods: 2005 and 2014/2015. Participants were classified as normoglycemic (fasting glucose <6.0 mmol/L) or dysglycemic (≥6.0 mmol/L). The researchers used univariate and logistic regression analyses to determine the factors that contributed to dysglycemia.

The prevalence of type 2 diabetes in the 2015 cohort was 15.1% compared with 6.8% in the 2005 cohort. Participants in the 2015 cohort were significantly older (median age of 49 years vs 41 years, P <.001), had a higher body mass index (27.4 kg/m² vs 24.9 kg/m² respectively, P =.019) and higher rates of hypertension (37.9% vs 19.6% respectively, P <.001) compared with the 2005 cohort.

The strongest predictors of dysglycemia in the 2015 cohort were hepatic steatosis and hypertension (odds ratios [OR] 6.74; 95% CI, 3.48-13.03 and OR 2.92; 95% CI, 1.66-5.16, respectively). HIV-related factors that predicted dysglycemia were weight gain following antiretroviral initiation and longer known duration of HIV infection (OR 1.07; 95% CI, 1.04-1.11 and OR 1.06; 95% CI, 1.02-1.10, respectively).

Investigators state, “Given the burden of [type 2 diabetes] in [people living with HIV/AIDS] there is an urgent need to mitigate these modifiable risk factors through intervention in terms of both prevention and treatment.”

Reference

Duncan AD, Goff LM, Peters BM. Type 2 diabetes prevalence and its risk factors in HIV: a cross-sectional study. PLoS One. 2018;13:e0194199.