HIV positive people more likely to develop diabetes
People with HIV are more likely to develop diabetes if they have used some older types of ARVs for a long time.
The risk is highest for people over 50 years, who started antiretroviral treatment before 1999 or had a longer exposure to older ARVs.
A study published in the journal BMJ Open Diabetes Research & Care, identifies the specific drugs as stavudine or first-generation ARVs such as nelfinavir or indinavir.
Researchers say the onset of diabetes was much less likely in people aged 50 and over who started treatment from 2010 onwards, or who started treatment at a higher CD4 cell count.
“The findings are likely to provide reassurance that modern HIV treatment carries little risk of promoting the development of diabetes in people with HIV,” said Nelson Otwoma, head of the National Empowerment Network of People living with HIV/AIDS in Kenya, a Nairobi-based lobby.
The BMJ study followed patients enrolled at a large HIV clinic in Canada between 1997 to 2015.
The results mirror other studies across the world which consistently link older ARVs formulations to higher risk for diabetes.
Diabetes mellitus, or type 2 diabetes, develops as a consequence of failures in the body’s ability to handle glucose.
It is more common in people who are obese and becomes more common with age.
“People with HIV are more likely to be diagnosed with type 2 diabetes but it is unclear to what extent HIV-related factors lead to a higher incidence of diabetes in people with HIV,” says the study.
National STIs Control Programme said only few Kenyans were on ARVs before the year 2000.
Kenya’s ARVs programme was only accelerated from 2002 and the country has consistently replaced older drugs with new formulations that have fewer side effects.
“The programme has seen the number of those accessing antiretroviral therapy increase from less than 10,000 in 2003 to over 430,000 in December 2010,” Nascop said in a statement.
Currently, about one million are actively taking ARVs in Kenya, although the number of those living with HIV is 1.5 million.
“Most new diabetes mellitus diagnoses occurred in an era when people living with HIV were exposed to first-generation ART agents with significant metabolic toxicities,” the authors said.
People who developed diabetes had significantly less exposure to the newer ARVs like tenofovir, atazanavir and darunavir compared to those who did not, reinforcing the authors’ conclusion that diabetes in people with HIV is chiefly a consequence of first-generation antiretroviral treatment.