title: A1C underestimates glycemia in HIV infection.
abstract: OBJECTIVE
  The objective of this study was to determine the relationship between A1C and glycemia in HIV infection.
  
  
  METHODS
  We completed a prospective cross-sectional study of 100 HIV-infected adults with type 2 diabetes (77%) or fasting hyperglycemia (23%) with measured glucose, A1C, mean corpuscular volume (MCV), and fructosamine. A total of 200 HIV-uninfected type 2 diabetic subjects matched for key demographic characteristics served as control subjects.
  
  
  RESULTS
  Relative to the control subjects, A1C underestimated glucose by 29 +/- 4 mg/dl in the HIV-infected subjects. Current nucleoside reverse transcriptase inhibitors (NRTIs), higher MCV and hemoglobin, and lower HIV RNA and haptoglobin were associated with greater A1C-glucose discordance. However, only MCV and current NTRI use, in particular abacavir, remained significant predictors in multivariate analyses. Fructosamine more closely reflected glycemia in the HIV-infected subjects.
  
  
  CONCLUSIONS
  A1C underestimates glycemia in HIV-infected patients and is related to NRTI use. Use of abacavir and increased MCV were key correlates in multivariate analyses. Fructosamine may be more appropriate in this setting.
authors.affiliation: Department of Infectious Diseases, Washington Hospital Center, Washington, DC, USA.
authors.forename: Peter S
authors.initials: PS
authors.lastname: Kim
authors.forename: Christian
authors.initials: C
authors.lastname: Woods
authors.forename: Patrick
authors.initials: P
authors.lastname: Georgoff
authors.forename: Dana
authors.initials: D
authors.lastname: Crum
authors.forename: Alice
authors.initials: A
authors.lastname: Rosenberg
authors.forename: Margo
authors.initials: M
authors.lastname: Smith
authors.forename: Colleen
authors.initials: C
authors.lastname: Hadigan
mesh_terms: D001786:Blood Glucose / Q000032:analysis*; D003430:Cross-Sectional Studies; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D015658:HIV Infections / Q000097:blood* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin