Abstract
Background: Human immunodeficiency virus (HIV) endocrinopathy involving the pancreas manifests clinically as dysglycaemia, including hypoglycaemia and hyperglycaemia. Dysglycaemia increases mortality in sick children, underlying the need for its evaluation and management. Objective: To assess the prevalence and risk factors of dysglycaemia in a cohort of antiretroviral therapy (ART)-naive children at the point of enrolment into a paediatric ART clinic of the Federal Medical Centre, Makurdi, Nigeria. Method: A retrospective cross-sectional study was carried out between June 2010 and June 2012. Hypoglycaemia was defined as random blood glucose level ˂2.2 mmol/l and hyperglycaemia as random blood glucose ˃6.6 mmol/l. Potential risk factors of dysglycaemia were tested for significance in bivariate and multivariate regression analyses. P -value less than 0.05 was considered to be significant. Results: 429 children, aged 1-15 years, including 223 males and 206 females were studied. The median age was 5 years. Twelve (2.8%) children had hypoglycaemia and 35 (8.2%) had hyperglycaemia. In multivariate regression analysis, no factor significantly predicted the risk of hypoglycaemia, whereas children co-infected with hepatitis C were at a significant risk of hyperglycaemia (adjusted odds ratio; 2.06, 95% CI; 1.05-8.52, P=0.03). Conclusions: In this study HIV-infected Nigerian children who were not on ART had a low prevalence of hypoglycaemia but a high prevalence of hyperglycaemia. Hepatitis C co-infection was a significant independent risk factor for hyperglycaemia. Sri Lanka Journal of Child Health, 2017; 46 (3): 248-258
Highlights
About 400,000 Nigerian children were living with human immunodeficiency virus (HIV) in 20131
No factor significantly predicted the risk of hypoglycaemia, whereas children co-infected with hepatitis C were at a significant risk of hyperglycaemia
In this study Human immunodeficiency virus (HIV)-infected Nigerian children who were not on antiretroviral therapy (ART) had a low prevalence of hypoglycaemia but a high prevalence of hyperglycaemia
Summary
About 400,000 Nigerian children were living with human immunodeficiency virus (HIV) in 20131. Before the access to Highly Active Anti-Retroviral Therapy (HAART), 50% of perinatally HIV infected children died before their second birthday[2]. HIV pancreatic dysfunctions manifest clinically as hypoglycaemia and hyperglycemia[7,8,9,10,11,12,13,14,15] and are seen in both antiretroviral therapy (ART)-experienced and ART-naïve patients[11,12]. Hommes et al.[12] reported that clinically stable HIV infected patients are protected against hyperglycaemia and diabetes as they were found to have increased sensitivity of peripheral tissues to insulin and increased nonoxidative glucose disposal[12]. Human immunodeficiency virus (HIV) endocrinopathy involving the pancreas manifests clinically as dysglycaemia, including hypoglycaemia and hyperglycaemia. Dysglycaemia increases mortality in sick children, underlying the need for its evaluation and management
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