HIV infection and the risk of diabetes mellitus

Abstract

Background The influence of HIV infection on the risk of diabetes is unclear. We determined the association and predictors of prevalent DM in HIV infected and uninfected veterans. Methods We determined baseline prevalence and risk factors for diabetes among HIV infected and uninfected veterans in the Veterans Aging Cohort Study. Logistic regression was used to determine the odds of diabetes in HIV infected and uninfected persons. Results We studied 3,327 HIV-infected and 3,240 HIV-uninfected subjects. HIV infected subjects were younger, more likely to be black race, male, have HCV coinfection and a lower body mass index (BMI). HIV infected subjects had a lower prevalence of diabetes at baseline (14.9% vs. 21.4%, P<0.0001). After adjustment for known risk factors, HIV infected individuals had a lower risk of diabetes (OR 0.84, 95% CI 0.72-0.97). Increasing age, male gender, minority race, and BMI were associated with an increased risk. The odds ratio for diabetes associated with increasing age, minority race and BMI were greater among HIV infected veterans. HCV coinfection and nucleoside and non-nucleoside reverse transcriptase inhibitor therapy were associated with a higher risk of diabetes in HIV infected veterans. Conclusion While HIV infection itself is not associated with increased risk of diabetes, increasing age, HCV coinfection and BMI have a more profound effect upon the risk of diabetes among HIV infected persons. Further, long term ARV treatment also increases risk. Future studies will need to determine whether incidence of DM differs by HIV status.

Incidence and predictors of cardiovascular disease, chronic kidney disease, and diabetes in HIV/HCV-coinfected patients who achieved sustained virological response

“…There is increasing evidence that the achievement of sustained virologic response (SVR) after pegylated interferon (peg-IFN) plus ribavirin (RBV) treatment reduces the incidence of hepatocellular carcinoma (HCC), liver decompensation, and overall mortality in HIV/HCV-coinfected patients [3][4][5][6]. Although HCV coinfection is associated with an increased risk of cardiovascular disease (CVD), chronic kidney disease (CKD), and diabetes mellitus (DM) among HIV-infected patients, the impact of SVR on the risk of the development of extrahepatic complications has been little investigated [7][8][9]. Therefore, we conducted this study to assess the impact of SVR on the incidence of extrahepatic events in a cohort of HIV/HCV-coinfected patients.…”

How Sweet It Is? Susceptibility to Diabetes Mellitus in HIV-1 Treatment

“…There are no conclusive data yet. However, data from the Veterans Aging Cohort Study from the USA supports this suggestion [19]. T2D prevalence was compared in over 3200 HIV-infected veterans to similar numbers of non-HIV-infected persons.…”

“…T2D prevalence was compared in over 3200 HIV-infected veterans to similar numbers of non-HIV-infected persons. T2D prevalence was 15% in HIV-infected subjects, compared with 21% in noninfected subjects, who were older and had a threefold higher prevalence of obesity [19]. No comparisons were made in BMI-matched controls to remove the expected effect of obesity.…”

Tuberculosis, HIV/AIDS and Diabetes – Is it Time to Think Together?

“…According to Butt et al [26] HIV infection is not having direct association with DM; however, the intake of anti-retroviral therapy (ART) increases the risk of developing DM. According to Brown et al [27,28] the incidence of DM was 4 times higher among the persons taking highly active ART (HAART), than that of HIV uninfected persons.…”