title: A Comparison of the Diabetes Risk Score in HIV/AIDS Patients on Highly Active Antiretroviral Therapy (HAART) and HAART-Naïve Patients at the Limbe Regional Hospital, Cameroon.
abstract: 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.
  
  
  
  Primarily to quantify and compare the risk of having diabetes mellitus in HIV/AIDS patients on HAART and HAART-naïve patients in Limbe, Cameroon; and secondarily to determine if there is an association between HAART and increased DM risk.
  
  
  
  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-naïve 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.
  
  
  
  The median DRS was significantly higher in patients on HAART (2.30%) than in HAART-naïve 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-naïve 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 HAART-naïve 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.
  
  
  
  HIV/AIDS patients on HAART could be at a greater risk of having DM than HAART-naïve patients as a result of the effect of HAART on risk factors of DM such as BMI and blood pressure.
authors.affiliation: Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Christian Akem
authors.initials: CA
authors.lastname: Dimala
authors.affiliation: Faculty of Health Sciences, University of Buea, Buea, Cameroon.
authors.forename: Julius
authors.initials: J
authors.lastname: Atashili
authors.affiliation: Faculty of Health Sciences, University of Buea, Buea, Cameroon.
authors.forename: Josephine C
authors.initials: JC
authors.lastname: Mbuagbaw
authors.affiliation: Faculty of Health Sciences, University of Buea, Buea, Cameroon.
authors.forename: Akam
authors.initials: A
authors.lastname: Wilfred
authors.affiliation: Faculty of Health Sciences, University of Buea, Buea, Cameroon.
authors.forename: Gottlieb L
authors.initials: GL
authors.lastname: Monekosso
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000188:drug therapy*; D000328:Adult; D000349:Africa; D000465:Algorithms; D023241:Antiretroviral Therapy, Highly Active; D001794:Blood Pressure; D002163:Cameroon; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D015215:Zidovudine / Q000008:administration & dosage
chemical_list: D015215:Zidovudine