title: Diabetes mellitus in HIV-infected patients receiving antiretroviral therapy.
abstract: BACKGROUND
  There is little in the literature on HIV and diabetes mellitus (DM) in sub-Saharan Africa.
  
  
  OBJECTIVE
  To assess the characteristics of HIV and DM in patients receiving antiretroviral therapy (ART) in Botswana.
  
  
  METHODS
  A retrospective case-control study was conducted at 4 sites. Each HIV-infected patient with DM (n=48) was matched with 2 HIV-infected controls (n=108) by age (±2 years) and sex. Primary analysis was conditional logistic regression to estimate univariate odds and 95% confidence intervals (CIs) for each characteristic.
  
  
  RESULTS
  There was no significant association between co-morbid diseases, tuberculosis, hypertension or cancer and risk of diabetes. DM patients were more likely to have higher pre-ART weight (odds ratio (OR) 1.09; 95% CI 1.04 - 1.14). HIV-infected adults >70 kg were significantly more likely to have DM (OR 12.30; 95% CI 1.40 - 107.98). Participants receiving efavirenz (OR 4.58; 95% CI 1.44 - 14.57) or protease inhibitor therapy (OR 20.7; 95% CI 1.79 - 240.02) were more likely to have DM. Neither mean pre-ART CD4 cell count (OR 1.0; 95% CI 0.99 - 1.01) nor pre-ART viral load >100 000 copies/ml (OR 0.71; 95% CI 0.21 - 2.43) were associated with a significant risk of diabetes.
  
  
  CONCLUSIONS
  These findings suggest a complex interrelation among traditional host factors and treatment-related metabolic changes in the pathogenesis of DM inpatients receiving ART. Notably, pre-ART weight, particularly if >70 kg, is associated with the diagnosis of diabetes in HIV-infected patients in Botswana.
authors.affiliation: Institute for Health Sciences, Gaborone, Botswana. michael.j.a.reid@gmail.com.
authors.forename: D
authors.initials: D
authors.lastname: Moyo
authors.forename: G
authors.initials: G
authors.lastname: Tanthuma
authors.forename: O
authors.initials: O
authors.lastname: Mushisha
authors.forename: G
authors.initials: G
authors.lastname: Kwadiba
authors.forename: F
authors.initials: F
authors.lastname: Chikuse
authors.forename: M S
authors.initials: MS
authors.lastname: Cary
authors.forename: A P
authors.initials: AP
authors.lastname: Steenhoff
authors.forename: M J A
authors.initials: MJ
authors.lastname: Reid
mesh_terms: D000328:Adult; D000480:Alkynes; D048588:Benzoxazines / Q000009:adverse effects; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D003521:Cyclopropanes; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D000480:Alkynes; D048588:Benzoxazines; D003521:Cyclopropanes; C098320:efavirenz