A Comparison of the Diabetes Risk Score in HIV/AIDS Patients on Highly Active Antiretroviral Therapy (HAART) and HAART-Naive Patients at the Limbe Regional Hospital, Cameroon

作者：Dimala Christian Akem^*; Atashili Julius; Mbuagbaw Josephine C; Wilfred Akam; Monekosso Gottlieb L

来源：PLos One, 2016, 11(5): e0155560.

DOI：10.1371/journal.pone.0155560

Background
Highly active antiretroviral therapy (HAART) has been associated with dysglycaemia. However, there is scarce data on the risk of developing diabetes mellitus (DM) in HIV/AIDS patients in Africa.
Objectives
Primarily to quantify and compare the risk of having diabetes mellitus in HIV/AIDS patients on HAART and HAART-naive patients in Limbe, Cameroon; and secondarily to determine if there is an association between HAART and increased DM risk.
Methods
A cross-sectional study was conducted at the Limbe Regional Hospital HIV treatment center between April and June 2013, involving 200 HIV/AIDS patients (100 on first-line HAART regimens for at least 12 months matched by age and gender to 100 HAART-naive patients). The Diabetes Risk Score (DRS) was calculated using a clinically validated model based on routinely recorded primary care parameters. A DRS >= 7% was considered as indicative of an increased risk of developing DM.
Results
The median DRS was significantly higher in patients on HAART (2.30%) than in HAARTnaive patients (1.62%), p = 0.002. The prevalence of the increased DM risk (DRS >= 7%) was significantly higher in patients on HAART, 31% (95% CI: 22.13-41.03) than in HAART-naive patients, 17% (95% CI: 10.23-25.82), p = 0.020. HAART was significantly associated with an increased DM risk, the odds ratio of the HAART group compared to the HAARTnaive group was 2.19 (95% CI: 1.12-4.30, p = 0.020). However, no association was found after adjusting for BMI-defined overweight, hypertension, age, sex, family history of DM and smoking (Odds ratio = 1.22, 95% CI: 0.42-3.59, p = 0.708). Higher BMI and hypertension accounted for the increased risk of DM in patients on HAART. Also, more than 82% of the participants were receiving or had ever used Zidovudine based HAART regimens.
Conclusion
HIV/AIDS patients on HAART could be at a greater risk of having DM than HAART-naive patients as a result of the effect of HAART on risk factors of DM such as BMI and blood pressure.

• 出版日期2016-5-19