A Comparison of Factors Associated With Prevalent Diabetes Mellitus Among HIV-Infected Antiretroviral-Naive Individuals Versus Individuals in the National Health and Nutritional Examination Survey Cohort

Abstract

In the general population, diabetes mellitus (DM) is associated with age, minority race/ethnicity, and obesity. Among HIV-infected persons, antiretroviral therapy (ART) use and hepatitis C virus (HCV) infection have been associated with DM. This study examined DM prevalence and its predictors in ART-naive HIV-infected patients. A cross-sectional analysis of ART-naive HIV-infected adults enrolled in 3 Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA) clinical trials versus adults enrolled in the National Health and Nutritional Examination Survey (NHANES). The prevalence of DM in the CPCRA clinical trials versus the NHANES was 3.3% versus 4.8%. The mean body mass index (BMI) was lower in the CPCRA trials versus the NHANES (25 kg/m vs. 28 kg/m). HCV was associated with DM only in univariate analyses in the CPCRA trials. In univariate and multivariate analyses, race/ethnicity, age, and BMI were associated with DM in both cohorts. Among women, age and BMI were associated with DM in both cohorts; race/ethnicity was associated with DM only in the NHANES. HCV was predictive of DM in blacks in the CPCRA trials (P = 0.004 before adjustment for multiple comparisons) but not in the full cohort. Our findings did not suggest an increased prevalence of DM in ART-naive HIV-infected patients. Although there was a trend toward increased prevalence of DM in HIV-HCV-coinfected patients, dominant risk factors associated with DM among ART-naive HIV-infected adults mirrored those of the general population.