HIV increases renal complications, hospitalization and mortality in diabetes mellitus
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AbstractBackground
Diabetes mellitus (DM) is more prevalent in HIV-infected individuals than in the general population. Little is known whether HIV increases the risk of DM complications and mortality. This study aims to compare glycemic control and prevalence of DM complications, hospitalization rates and mortality between HIV-infected and uninfected individuals with DM.

Methods
A retrospective case-control study was performed. All HIV-infected individuals with DM followed up in an infectious diseases clinic were identified. HIV-uninfected controls matched for age, gender, and year of DM diagnosis at 1:2 ratio, were identified from a territory-wide DM complication screening programme. Serial HbA1c were compared using generalised estimating equations. DM-related complications (end-stage renal failure, cardiovascular diseases, retinopathy, neuropathy, and cancers), hospitalization rates, and mortality were compared between HIV-infected and uninfected individuals, in multivariable Cox hazard proportional models.

Results
Eighty-nine HIV-infected individuals and 178 matched HIV-uninfected controls were included for analysis: mean±SD age at DM diagnosis 49±10 years, male 89%, follow-up duration 10±5 years. HIV-infected individuals had a mean duration of HIV diagnosis of 14±6 years, 39% had AIDS, current CD4 562±232 cells/mm3, and 92% undetectable viral load. 31% were receiving NNRTIs, 42% protease inhibitors, and 34% integrase inhibitors. Compared with HIV-uninfected controls, fewer HIV-infected individuals had obesity, while more of them were receiving insulin, anti-hypertensives, and statin (Table).

HIV-infected individuals had lower median HbA1c at the time of DM diagnosis (7.2% vs 7.5%, p=0.021), and were more likely to have HbA1c <7% during follow-up (Figure 1). Significantly more HIV-infected individuals had end-stage renal failure (ESRF) (10.1% vs 3.4%, p=0.024). After adjusting for confounding baseline variables, HIV-infected individuals had higher rate of hospitalization (Figure 2a). Mortality was associated with HIV infection and lack of statin use (Figure 2b).

Conclusion
DM with HIV infection was associated with higher risk of ESRF, hospitalization and mortality than their HIV-uninfected counterparts.
All Author(s) ListLui G, Lau SH, Wong NS, Yung IMH, Wong RYK, Kong AP
Name of Conference16th European AIDS Conference
Start Date of Conference25/10/2017
End Date of Conference27/10/2017
Place of ConferenceMilan
Country/Region of ConferenceItaly
Year2017
LanguagesEnglish-United Kingdom

Last updated on 2018-23-10 at 17:15