Open AccessDiabetes mellitus burden among people living with HIV from the Asia‐Pacific region
Author(s) -
Han Win M,
Jiamsakul Awachana,
Kiertiburanakul Sasisopin,
Ng Oon T,
Sim Benedict LH,
Sun Ly P,
Van Nguyen Kinh,
Choi Jun Y,
Lee Man P,
Wong Wing W,
Kamarulzaman Adeeba,
Kumarasamy Nagalingeswaran,
Zhang Fujie,
Tanuma Junko,
Do Cuong D,
Chaiwarith Romanee,
Merati Tuti P,
Yunihastuti Evy,
Pujari Sanjay,
Ditangco Rossana,
Khusuwan Suwimon,
Ross Jeremy,
Avihingsa Anchalee
Publication year - 2019
Publication title -
journal of the international aids society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.724
H-Index - 62
ISSN - 1758-2652
DOI - 10.1002/jia2.25236
Subject(s) - medicine , interquartile range , confidence interval , diabetes mellitus , incidence (geometry) , hazard ratio , proportional hazards model , cohort , cohort study , antiretroviral therapy , human immunodeficiency virus (hiv) , endocrinology , viral load , immunology , physics , optics
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 < 0.001) compared to <2010, older age (41 to 50 years: HR = 2.46, 95% CI 1.39 to 4.36, p = 0.002; and >50 years: HR = 4.19, 95% CI 2.12 to 8.28, p < 0.001) compared to <30 years, body mass index ( BMI ) >30 kg/m 2 ( HR = 4.3, 95% CI 1.53 to 12.09, p = 0.006) compared to BMI <18.5 kg/m 2 , 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.