Endocrine Abstracts

Background: Highly active antiretroviral therapy (HAART) particularly protease inhibitors cause hyperglycaemia through insulin resistance. There is raising number of HIV patients on HAART attending the diabetic clinic in Nigeria and very few studies were done to determine their risk of developing diabetes. We aimed to determine the prevalence and factors associated with diabetes mellitus (DM) among HIV patients.

Methods: In a cross sectional study of 300 HIV patients at the AKTH Kano, we assessed the glycaemic parameters and anthropometry of study participants. The patients were evaluated as per HAART-treated and HAART-naïve groups and the results compared for the two groups. Fasting plasma glucose (FPG) was determined using glucose oxidase method after an overnight fast and WHO criteria was used to define diabetes mellitus as FPG ≥7.0 mmol/l.

Results: The mean±S.D. age of the study participants was 34.8±9.9 years with a male to female ratio of 1:2. The prevalence of DM was found to be 7.3%. Prevalence among HAART-treated was 12.0% while among HAART-naive participants was 2.7% (P=0.001). Among the HAART-treated, older age, exposure to protease inhibitor based regimen, longer duration of HIV diagnosis, and HAART exposure, increased CD4 cell count, abnormal waist circumference, and presence of hypertension were found to be associated with the occurrence of DM (P<0.05). Among the HAART-naïve longer duration of HIV infection and the presence of abnormal waist circumference were found to be associated with the development of DM. Increased waist circumference (OR 4.4; 95% CI, 1.5–12.7; P<0.05) and presence of hypertension (OR 5.4; 95% CI, 1.9–15.1; P<0.05) were found to be independent predictors for the development of DM.

Conclusion: HAART exposure causes disturbances of glucose metabolism among HIV patients. Plasma glucose evaluation should form part of the routine investigations among HIV patients particularly those on HAART.