Age, Exposure to Antiretrovirals Affect Diabetes Risk in HIV

HIV in blood stream
HIV in blood stream
Interventions for diabetes prevention and management may be needed to reduce the risk for diabetes in patients with 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.

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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.