Diabetes mellitus and risk factors in human immunodeficiency virus-infected individuals at Jimma University Specialized Hospital, Southwest Ethiopia

Mohammed, Abdurehman Eshete; Shenkute, Tilahun Yemane; Gebisa, Waqtola Cheneke

doi:10.2147/dmso.s80084

Cited by 40 publications

(77 citation statements)

References 26 publications

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“…5 Similarly, another study shows that the natural course of HIV infection is characterised by reductions in HDL-cholesterol. 5 Other studies also indicate that weight loss and protein depletion contribute to the reduction in HDL-cholesterol in this group of patients.…”

Section: Key Resultsmentioning

confidence: 97%

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Diabetes mellitus among HIV-infected individuals in follow-up care at University of Gondar Hospital, Northwest Ethiopia

et al. 2016

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ObjectiveTo assess the prevalence of diabetes mellitus (DM) and associated factors among HIV-infected adults in northwest Ethiopia.DesignHospital-based cross-sectional study.SettingHIV clinic of the University of Gondar Hospital, Ethiopia.ParticipantsAll HIV-infected adults who visited the HIV clinic from December 2013 to the end of February 2014 were the source population.MeasuresA structured and pretested questionnaire incorporating the WHO STEPwise approach was used. A multivariate logistic regression analysis was applied to assess factors associated with DM.ResultsThe overall prevalence of type 2 DM was 8% (95% CI 5.5% to 10.5%). The prevalence of DM was higher (13.2%; 95% CI 8.0% to 18.3%) among subjects receiving pre-antiretroviral treatment (pre-ART) than among those taking ART (5.1%; 95% CI 2.6% to 7.6%). Thirteen (35.1%) of the DM cases were newly identified during the study. Obesity (adjusted OR (AOR) 6.55; 1.20 to 35.8), hypertension (AOR 3.45; 1.50 to 7.90), being in the pre-ART group (AOR 4.47; 1.80 to 11.08), hypertriglyceridaemia (AOR 2.24; 1.02 to 49.5) and tertiary-level education (AOR 11.8; 2.28 to 61.4) were associated with DM.ConclusionsOverall DM prevalence was high, particularly among subjects in the pre-ART group. More educated, hypertensive and obese HIV-infected adults were more likely to have DM as a comorbidity. Health policy and the clinical management of HIV-infected individuals should take into account the rising DM.

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Section: Key Resultsmentioning

confidence: 97%

“…5 The final sample size was 483, as calculated using Epi Info V.7. Every person aged 15 years and above was selected from 40-60 HIV and AIDS patients who visited the clinic every day.…”

Section: Sample Sizementioning

confidence: 99%

Diabetes mellitus among HIV-infected individuals in follow-up care at University of Gondar Hospital, Northwest Ethiopia

et al. 2016

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“…After screening, 20 articles met the eligibility criteria [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] and were included in the analysis (figure 1). Of these, seven 17-23 articles reported incidence of T2DM in HIV-infected participants, eight 24-31 reported prevalence of T2DM in HIV-infected participants compared with uninfected controls and five 32-36 reported prevalence of T2DM in HIV-infected participants on treatment compared with untreated controls.…”

Section: Resultsmentioning

confidence: 99%

Incidence and prevalence of type 2 diabetes mellitus with HIV infection in Africa: a systematic review and meta-analysis

et al. 2017

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ObjectivesThis systematic review aims to investigate the incidence and prevalence of type 2 diabetes mellitus (T2DM) in patients with HIV infection in African populations.SettingOnly studies reporting data from Africa were included.ParticipantsA systematic search was conducted using four databases for articles referring to HIV infection and antiretroviral therapy, and T2DM in Africa. Articles were excluded if they reported data on children, animals or type 1 diabetes exclusively.Main outcome measuresIncidence of T2DM and prevalence of T2DM. Risk ratios were generated for pooled data using random effects models. Bias was assessed using an adapted Cochrane Collaboration bias assessment tool.ResultsOf 1056 references that were screened, only 20 were selected for inclusion. Seven reported the incidence of T2DM in patients with HIV infection, eight reported the prevalence of T2DM in HIV-infected versus uninfected individuals and five reported prevalence of T2DM in HIV-treated versus untreated patients. Incidence rates ranged from 4 to 59 per 1000 person years. Meta-analysis showed no significant differences between T2DM prevalence in HIV-infected individuals versus uninfected individuals (risk ratio (RR) =1.61, 95% CI 0.62 to 4.21, p=0.33), or between HIV-treated patients versus untreated patients (RR=1.38, 95% CI 0.66 to 2.87, p=0.39), and heterogeneity was high in both meta-analyses (I2=87% and 52%, respectively).ConclusionsMeta-analysis showed no association between T2DM prevalence and HIV infection or antiretroviral therapy; however, these results are limited by the high heterogeneity of the included studies and moderate-to-high risk of bias, as well as, the small number of studies included. There is a need for well-designed prospective longitudinal studies with larger population sizes to better assess incidence and prevalence of T2DM in African patients with HIV. Furthermore, screening for T2DM using gold standard methods in this population is necessary.Trial registration numberPROSPERO42016038689.

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“…From 602 records identified through electronic database searching, 19 records from cross‐references, and 28 417 records from the WHO International Clinical Trials Registry Platform, we excluded 560 abstracts and 11 duplicate records. Of 50 remaining full texts assessed for eligibility, 9 articles were withdrawn, leaving 41 studies that were deemed eligible for inclusion in the meta‐analyses . In total, there were 20 178 participants, with approximately twice as many ART‐exposed as there were ART‐naïve patients.…”

Section: Resultsmentioning

confidence: 99%

Is there sufficient evidence for a causal association between antiretroviral therapy and diabetes in HIV‐infected patients? A meta‐analysis

Nduka

Stranges

Kimani

et al. 2017

Diabetes Metabolism Res

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The association of antiretroviral therapy (ART) with diabetes is inconsistent and varies widely across primary epidemiological studies. A comprehensive and more precise estimate of this association is fundamental to establishing a plausible causal link between ART and diabetes. We identified epidemiological studies that compared mean fasting plasma glucose (FPG) concentrations and proportions of diabetes and metabolic syndrome between HIV-infected patients naïve and exposed to ART. Mean difference in FPG concentrations and odds ratios of diabetes and metabolic syndrome were pooled using random-effects meta-analyses. Data on 20 178 participants from 41 observational studies were included in the meta-analyses. Mean FPG concentrations (Pooled mean difference: 4.66 mg/dL; 95% confidence interval [CI], 2.52 to 6.80; 24 studies) and the odds of diabetes (Pooled odds ratios: 3.85; 95% CI, 2.93 to 5.07; 10 studies) and metabolic syndrome (Pooled odds ratios: 1.45; 95% CI, 1.03 to 2.03; 18 studies) were significantly higher among ART-exposed patients, compared to their naïve counterparts. ART was also associated with significant increases in FPG levels in studies with mean ART duration ≥18 months (Pooled mean difference: 4.97 mg/dL; 95% CI, 3.10 to 6.84; 14 studies), but not in studies with mean ART duration <18 months (Pooled mean difference: 4.40 mg/dL, 95% CI, -0.59 to 9.38; 7 studies). ART may potentially be the single most consistent determinant of diabetes in people living with HIV worldwide. However, given the preponderance of cross-sectional studies in the meta-analysis, the association between ART and diabetes cannot be interpreted as cause and effect.

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Diabetes mellitus and risk factors in human immunodeficiency virus-infected individuals at Jimma University Specialized Hospital, Southwest Ethiopia

Cited by 40 publications

References 26 publications

Diabetes mellitus among HIV-infected individuals in follow-up care at University of Gondar Hospital, Northwest Ethiopia

Diabetes mellitus among HIV-infected individuals in follow-up care at University of Gondar Hospital, Northwest Ethiopia

Incidence and prevalence of type 2 diabetes mellitus with HIV infection in Africa: a systematic review and meta-analysis

Is there sufficient evidence for a causal association between antiretroviral therapy and diabetes in HIV‐infected patients? A meta‐analysis

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