Endocrine Abstracts

Background: The exposure to HAART has increased the chances of developing Diabetes among HIV patients. Hyperglycaemia is more common among those on Protease inhibitors (PI)-based regimens compared to other regimens. Glycated hemoglobin (HbA1c ) is now being recommended by the American Diabetes Association (ADA) for the screening of Diabetes because of convenience as it does not require fasting.

Objective: We aimed to determine the change in glycated hemoglobin after the commencement of HAART and the factors associated with this change.

Methodology: It was a longitudinal prospective study. One hundred and eighty HIV patients that met HAART criteria were recruited before the commencement of therapy. Their HbA1c and other anthropometric parameters were measured. Six months into HAART, the HbA1c, and other indices were repeated. Only data of 150 participants were available at the end of the study.

Results: The mean age of the participants was 35.7±10.0 years, and 64% of them were females. The mean pre-HAART HbA1c was 4.2±0.7% while the post-HAART HbA1c was 4.8±1.3% with a statistically significant difference (P=0.000). Based on the ADA criteria for screening of Diabetes and Prediabetes in asymptomatic adults using HbA1c, 97.4% of the participants were normal, 1.3% in the Prediabetes range and 1.3% were in the Diabetes range also. Following HAART exposure, 87.3% were found to be normal, 4.7% were in the Prediabetes range while 8% were in the Diabetes scale (P=0.005). The factors that were discovered to be associated with the development of Prediabetes or Diabetes among the study participants following HAART include age more than 40 years, longer duration of HIV infection and HAART, exposure to PI-based regimen, increase body mass index and increase waist circumference (P<0.05).

Conclusion: Exposure to HAART particularly Protease inhibitors cause hyperglycemia and its attendant complications in HIV patients. There is the need for regular metabolic screening and follow-up among these patients, and glycated hemoglobin is useful for screening.