The association between HIV tri-therapy with the development of Type-2 Diabetes Mellitus in a rural South African District: A case-control study

• Published in: PloS one 2020-12, Vol.15 (12), p.e0244067
• Main Authors: Bam, Nokwanda E, Mabunda, Sikhumbuzo A, Ntsaba, Jafta, Apalata, Teke, Nomatshila, Sibusiso C, Chitha, Wezile
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adult; AIDS; Antiretroviral agents; Antiretroviral drugs; Biology and Life Sciences; Blood pressure; Comorbidity; Complications; Complications and side effects; Confidence intervals; Consent; Development and progression; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 2 - chemically induced; Diabetes Mellitus, Type 2 - epidemiology; Drug dosages; Drug therapy; Drugs; Female; Health aspects; Health care facilities; Highly active antiretroviral therapy; HIV; HIV Infections - drug therapy; HIV Infections - epidemiology; Human immunodeficiency virus; Humans; Information systems; Insulin resistance; Male; Medicine and Health Sciences; Metabolic disorders; Metabolism; Middle Aged; Primary care; Prospective Studies; Protease inhibitors; Proteinase inhibitors; Quality of life; Questionnaires; Random sampling; Research and Analysis Methods; Risk factors; Ritonavir; Rural areas; Rural Population; South Africa - epidemiology; Statistical sampling; Statistics; Stavudine; Stavudine - administration & dosage; Stavudine - adverse effects; Time Factors; Type 2 diabetes; Zidovudine; Zidovudine - administration & dosage; Zidovudine - adverse effects
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0244067

Combination antiretroviral drugs (cARVs) prolong patients' lives but are unfortunately thought to increase complications related to metabolic disorders including type-2 Diabetes Mellitus (DM). We sought to confirm the association of cARVs with type-2 DM and ascertain the extent of this association in a rural South African setting. A case-control study of 177 (33.33%) cases with HIV/AIDS and type-2 DM were selected and compared with 354 (66.67%) non-DM HIV/AIDS unmatched controls from a rural district of South Africa's third most populous province (Eastern Cape). Cases were identified from community health centres using the district health information system, and controls were identified using simple random sampling from the same health facilities. Odds Ratios (OR), together with 95% confidence intervals, were calculated for all the univariable and multivariable logistic analyses. This study found that cARVs significantly increased the occurrence of type-2 DM among HIV patients. Patients on protease inhibitors (PIs) were at least 21 times significantly (p