Affiliations 

  • 1 HIV-NAT/Thai Red Cross AIDS Research Centre, Bangkok, Thailand
  • 2 The Kirby Institute, UNSW, Sydney, Australia
  • 3 Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • 4 Tan Tock Seng Hospital, Singapore, Singapore
  • 5 Hospital Sungai Buloh, Sungai Buloh, Malaysia
  • 6 National Center for HIV/AIDS, Dermatology & STDs, Phnom Penh, Cambodia
  • 7 National Hospital for Tropical Diseases, Hanoi, Vietnam
  • 8 Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
  • 9 Queen Elizabeth Hospital, Hong Kong SAR
  • 10 Taipei Veterans General Hospital, Taipei, Taiwan
  • 11 University Malaya Medical Centre, Kuala Lumpur, Malaysia
  • 12 Chennai Antiviral Research and Treatment Clinical Research Site (CART CRS), YRGCARE Medical Centre, VHS, Chennai, India
  • 13 Beijing Ditan Hospital, Capital Medical University, Beijing, China
  • 14 National Center for Global Health and Medicine, Tokyo, Japan
  • 15 Bach Mai Hospital, Hanoi, Vietnam
  • 16 Research Institute for Health Sciences, Chiang Mai, Thailand
  • 17 Faculty of Medicine, Udayana University & Sanglah Hospital, Bali, Indonesia
  • 18 Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
  • 19 Institute of Infectious Diseases, Pune, India
  • 20 Research Institute for Tropical Medicine, Muntinlupa City, Philippines
  • 21 Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand
  • 22 TREAT Asia, amfAR - The Foundation for AIDS Research, Bangkok, Thailand
PMID: 30697944 DOI: 10.1002/jia2.25236

Abstract

INTRODUCTION: Comorbidities including diabetes mellitus (DM) among people living with HIV (PLHIV) are of increasing clinical concerns in combination antiretroviral therapy (cART) era. We aimed to determine the incidence and risk factors of new-onset DM among PLHIV in Asian settings.

METHODS: PLHIV from a regional observational cohort without DM prior to antiretroviral therapy (ART) initiation were included in the analysis. DM was defined as having a fasting blood glucose ≥126 mg/dL, glycated haemoglobin ≥6.5%, a two-hour plasma glucose ≥200 mg/dL, or a random plasma glucose ≥200 mg/dL. A Cox regression model, stratified by site, was used to identify risk factors associated with DM.

RESULTS AND DISCUSSION: Of the 1927 participants included, 127 were diagnosed with DM after ART initiation. Median follow-up time from ART initiation to DM diagnosis was 5.9 years (interquartile range (IQR): 2.8 to 8.9 years). The crude incidence rate of DM was 1.08 per 100 person-years (100 PYS), 95% confidence interval (CI) (0.9 to 1.3). In the multivariate analysis, later years of follow-up (2011 to 2013: HR = 2.34, 95% CI 1.14 to 4.79, p = 0.02; and 2014 to 2017: HR = 7.20, 95% CI 3.27 to 15.87, p 50 years: HR = 4.19, 95% CI 2.12 to 8.28, p 30 kg/m2 (HR = 4.3, 95% CI 1.53 to 12.09, p = 0.006) compared to BMI <18.5 kg/m2 , and high blood pressure (HR = 2.05, 95% CI 1.16 to 3.63, p = 0.013) compared to those without high blood pressure, were associated with developing DM. The hazard was reduced for females (HR = 0.47, 95% CI 0.28 to 0.80, p = 0.006).

CONCLUSIONS: Type 2 DM in HIV-infected Asians was associated with later years of follow-up, high blood pressure, obesity and older age. This highlights the importance of monitoring and routine screening for non-communicable diseases including DM as PLHIV age.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.