Abstract
The risk of developing Type 2 Diabetes Mellitus in people living with HIV (PLWH) can be four times greater and can occur at an earlier age and even without the presence of obesity compared to those without HIV. Therefore, the purpose of this analytical cross-sectional study was to determine the relationship between HIV duration and glucose metabolism among PLWH. Eighty-two PLWH were categorized into shorter (≤15 years) or longer HIV duration (≥16 years) and then compared for differences in demographics, physical and clinical characteristics, biomarkers, and dietary intake. Compared to those with shorter HIV duration (n = 34), those with longer HIV duration (n = 48) were on average older (p = 0.02), reported lower consumption of alcohol (p = 0.05), had higher levels of homeostasis model assessment of insulin resistance (HOMA-IR, p = 0.02), were also more likely to be a woman (p = 0.06), and have higher levels of fasting insulin (p = 0.06). When adjusted for age and body weight, the levels of HOMA-IR and fasting insulin were higher (p = 0.02 and p = 0.04) with longer compared to shorter HIV duration, respectively. Longer exposure to HIV infection is associated with impaired insulin sensitivity. Continuing research aimed at the long-term effects of HIV infection and (antiretroviral therapy) is required.
Highlights
With the use and advancement of antiretroviral therapy (ART), human immunodeficiency virus (HIV) has transitioned from a deadly disease to a chronic and manageable condition [1,2]
The average number of years since HIV diagnoses was 16 ± 7, with 59% of individuals being exposed to HIV for ≥ 16 years and 41% of individuals for < 16 years
We demonstrated that the duration of HIV infection, and the use of ART, may further elucidate a possible metabolic dysregulation in people living with HIV (PLWH)
Summary
With the use and advancement of antiretroviral therapy (ART), human immunodeficiency virus (HIV) has transitioned from a deadly disease to a chronic and manageable condition [1,2]. Marked improvements in ARTs potency and side-effect profile, coupled with their greater availability and ease of use, have led to a dramatic increase in life expectancy of people living with HIV (PLWH). PLWH and their health care professionals face increased challenges for complex care of emerging non-communicable diseases, including. The risk of developing T2DM in PLWH, compared to those without HIV, can be up to four times greater [7] and can occur at an earlier age and without obesity [8]. The etiology of T2DM is multifactorial and besides conventional risk factors, the aging PLWH deals with prolonged exposure to HIV and ART, as potential determinants of excess glycemic burden and overall T2DM risk [2,9]
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