Co-morbidity of diabetes mellitus and HIV in patients attending the ART clinic Parirenyatwa hospital 2015

Abstract

Background: Zimbabwe has a double burden of diseases, with HIV epidemic and increased prevalence of diabetes mellitus. Since the roll out of Anti Retroviral Therapy in 2004 at Parirenyatwa OI clinic, Nucleoside Reverse Transcriptase Inhibitors have been the backbone of antiretroviral therapy. At least 10% of OI clients at the institution are on 2nd line regimen with Protease Inhibitors. These drugs cause metabolic derangements which are potentially Diabetogenic. With improved care in HIV management, patients are living long enough to experience environmental and behavioural risk factors for diabetes mellitus. However diabetic screening is not done at Parirenyatwa OI clinic and the disease burden of HIV/Diabetes co-morbidity is not known. Methods: An analytic cross-sectional study was conducted. Questionnaires were used to collect data on patient’s socio-demographic characteristics, medical history and symptoms of diabetes mellitus. Random blood sugar and glycated haemoglobin tests were done to ascertain diabetes status. Results: Prevalence of diabetes was 15.42%. Treatment with Protease inhibitors (POR 2.36; 95% CI 1.06-5.23) and a CD4 count at diagnosis of HIV greater than 500 (POR 3.74; 95% CI 1.26-11.09) were associated with development of diabetes mellitus with statistical significance. Smoking (POR 2.34; 95% CI 0.69-7.96), alcohol abuse (POR 1.81; 95% CI 0.74-4.40) being overweight (POR 1.79; 95% CI 0.85-3.79), were also associated with the development of diabetes but not statistically significant. Conclusions: Behavioural risk factors like smoking, alcohol use and being overweight were associated with developing diabetes. Protease inhibitors use was also associated with the development of diabetes mellitus.