Abstract
People living with HIV and AIDS are exposed to the challenges of aging and diet related diseases due to prolonged survival by retroviral drugs. The presence of chronic inflammatory state and the metabolic effects of antiretroviral therapy are additional burden. This study was designed to determine the changes in glucose metabolism in HIV infection. This was a case-control study carried out at the adult HIV clinic. Consenting participants were grouped into four; those on nucleoside reverse transcriptase inhibitor/non-nucleoside reverse transcriptase inhibitor (NRTI/NNRTI) (group 1), those on NRTI/PI (group 2), those that were treatment naive (group 3) and age and sex matched HIV negative controls (group 4). Questionnaires were used to assess the demography of participants. The weight and height of participants were done. Blood was collected for fasting blood sugar, 2 h post prandial glucose and CD4 count. The body mass index (BMI) was significantly lower in the participants on protease inhibitors. The control group had lower 2HPP glucose despite a higher FBS than the other groups that were HIV positive. Treatment naive (group 3) tend to have higher 2-hour post-prandial blood sugar (2HPP) glucose tests (p= 0.04). The male HIV positive participants on PI also had significantly higher 2HPP glucose tests (p=0.01). The females had lower fasting blood sugar (FBS) and 2HPP glucose tests than the males. There were no correlations of glucose metabolism with CD4 count, age or BMI. The higher 2HPP glucose tests in participants who are treatment naive may be explained by insulin resistance associated with chronic inflammatory state. It is therefore recommended that HAART be commenced early. Key words: Human immunodeficiency virus, glucose metabolism, highly active antiretroviral therapy.
Highlights
Patients with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) are increasing in number
HIV patients are exposed to age related diseases such as hypertension, diabetes, cancers, myocardiopathies and dyslipidemia in association with the long term metabolic effects of highly active antiretroviral therapy (HAART) and chronic inflammation of HIV infection (Saves et al, 2002; Levitt and Bradshaw, 2006)
The consequences are the emergence of metabolic syndromes such as lipodystrophy, cardiovascular disease and disorders of glucose metabolism among people living with HIV and AIDS (Samaras, 2012)
Summary
Patients with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) are increasing in number. This is partly due to improved screening, early diagnosis, improved therapy and greater. Short-term exposure to stavudine, for example, can reduce insulin sensitivity in healthy volunteers (Fleischman et al, 2007) It is associated with accelerated development of lipodystrophy and pancreatitis leading to development of diabetes (Carr et al, 2003; Daar et al, 2011). It was expected that the outcome of the study will increase awareness among clinicians and contribute to knowledge on those at risk, when to screen and the appropriate but simple parameter to monitor
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