Human Immunodeficiency Virus and Risk of Type 2 Diabetes in a Large Adult Cohort in Jos, Nigeria.
Human immunodeficiency virus (HIV) infection and the use of antiretroviral therapy (ART) may increase the risk of type 2 diabetes mellitus (T2DM). However, data from regions with a high burden of HIV/AIDS are 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.



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



Baseline T2DM prevalence was 2.3% (95% confidence interval, 1.8%-2.9%); age, but not body mass index (BMI), was a risk factor for diabetes. After 12 months of ART, an additional 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.



Diabetes is not uncommon in HIV-infected individuals at the time of presentation to HIV services. Patients initiating ART have a high risk of developing diabetes in the first year of ART. Excessive weight gain should be avoided, as incident diabetes was associated with a BMI ≥25.0 kg/m(2).
Department of Medicine, University of Jos and Jos University Teaching Hospital Prevention Initiative of Nigeria Clinic, Jos University Teaching Hospital.
Samson E
SE
Isa
Department of Medicine, University of Jos and Jos University Teaching Hospital Prevention Initiative of Nigeria Clinic, Jos University Teaching Hospital.
Agbaji O
AO
Oche
Department of Clinical Sciences, Liverpool School of Tropical Medicine, United Kingdom.
Arthur R
AR
Kang'ombe
Prevention Initiative of Nigeria Clinic, Jos University Teaching Hospital Department of Microbiology, University of Jos.
Joseph A
JA
Okopi
Department of Medicine, University of Jos and Jos University Teaching Hospital National Agency for the Control of AIDS, Abuja, Nigeria.
John A
JA
Idoko
Department of Clinical Sciences, Liverpool School of Tropical Medicine, United Kingdom.
Luis E
LE
Cuevas
Department of Clinical Sciences, Liverpool School of Tropical Medicine, United Kingdom.
Geoffrey V
GV
Gill
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D012307:Risk Factors
D019380:Anti-HIV Agents
HIV/AIDS; Nigeria; antiretroviral therapy; antiretrovirals; diabetes