HIV and risk of type 2 diabetes in a large adult cohort in Jos, Nigeria.

BACKGROUND

HIV infection and the use of anti-retroviral therapy (ART) may increase the risk of type 2 diabetes mellitus (T2DM). However, data from regions with a high burden of HIV/AIDS is limited. We determined the prevalence of T2DM at the time of presentation to a large HIV Clinic in Nigeria, as well as the incidence of diabetes 12 months following ART initiation.

METHODS

Data from patients enrolled for ART from 2011 to 2013 was analyzed, including 2632 patients on enrollment and 2452 re-evaluated after 12 months of ART commencement. The presence of diabetes, demographic, clinical and biochemical data were retrieved from standardized databases. CD4+, HIV viral load, and hepatitis C virus (HCV) status were noted. Bivariate and logistic regressions were used to identify risk factors for T2DM.

RESULTS

Baseline T2DM prevalence was 2.3% (95%CI: 1.8% - 2.9%), and age, but not body mass index (BMI) was a risk factor for diabetes. After 12 months of ART, a further 5.3% had developed T2DM. Newly developed diabetes was not associated with age, but was associated with BMI. There were no significant associations between prevalent or incident diabetes and CD4+, viral load or type of ART.

CONCLUSIONS

Diabetes is not uncommon in HIV infected individuals at the time of presentation to HIV services. Patients initiating ART then have a high risk of developing diabetes in the first year of ART. Incident diabetes was associated with a BMI≥25.0, and excessive weight gain should be avoided.