Type 2 diabetes: what are the risk factors in HIV?

Takeaway

• The prevalence of HIV is alarmingly high in patients with type 2 diabetes (T2DM).
• Compared to 2005 the 2015 cohort were older and were exposed to long-term use of antiretroviral (ARV) medications.
• Effective strategies targeting both conventional risk factors, such as abdominal obesity, and HIV-specific risk factors like weight gain following ARV initiation are urgently needed.

Why this matters

• Because of the availability of ARV, patients with HIV are living longer but are becoming overweight and have abdominal obesity and are now comparable with the general population.

Study design

• Cross-sectional study evaluating a cohort studied in 2015 consisting of patients with HIV (n=338) and comparing them with a cohort studied in 2005 (n=337).
• Funding: None disclosed.

Key results

• Prevalence of T2DM was significantly higher in 2015 vs 2005 (15.1% vs 6.8%; P=.003).
• Dysglycaemia was significantly associated with increased risk for hypertension (2005: P=.001; 2015: P<.001), duration of HIV infection (2005: P=.046; 2015: P<.001) and use of ARVs (2005: P=.018; 2015: P=.009).
• In 2015 cohort, a significant association between diabetes and BMI was observed (2005: P=.878, P=.423; 2015: P=.002, P=.001, respectively).
• In 2015, the strongest predictors of dysglycaemia were hepatic steatosis (OR, 7.28, P<.001) and hypertension (OR, 2.58; P=.003).
• Weight gain was seen after ARV use (OR, 1.07) and long-term duration of HIV infection (OR, 1.06).

Limitations

• Lack of HIV-negative control group.