HIV and type 2 diabetes: An evolving story

IF 2.8 3区医学 Q2 INFECTIOUS DISEASES HIV Medicine Pub Date : 2023-12-18 DOI:10.1111/hiv.13595

Harriet Daultrey, Tom Levett, Nick Oliver, Jaime Vera, Ali J Chakera

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Abstract

Introduction

Diabetes is widely reported to be more common in people living with HIV (PLWH). Much of the data supporting this originated during the earlier HIV era. The perceived increased risk of type 2 diabetes is reflected in HIV clinical guidelines that recommend screening for diabetes in PLWH on anti-retroviral therapy (ART). However, international HIV clinical guidelines do not agree on the best marker of glycaemia to screen for diabetes. This stems from studies that suggest HbA1c underestimates glycaemia in PLWH.

Methods

Within this review we summarise the literature surrounding the association of HIV and type 2 diabetes and how this has changed over time. We also present the evidence on HbA1c discrepancy in PLWH.

Conclusion

We suggest there is no basis to any international guidelines to restrict HbA1c based on HIV serostatus. We recommend, using the current evidence, that PLWH should be screened annually for diabetes in keeping with country specific guidance. Finally, we suggest future work to elucidate phenotype and natural history of type 2 diabetes in PLWH across all populations.

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艾滋病毒与 2 型糖尿病：不断演变的故事。

导言：据广泛报道，糖尿病在艾滋病病毒感染者（PLWH）中更为常见。支持这一观点的数据大多源自早期的艾滋病时代。艾滋病临床指南建议对接受抗逆转录病毒疗法（ART）的艾滋病病毒感染者进行糖尿病筛查，这反映了人们对 2 型糖尿病风险增加的认识。然而，国际艾滋病临床指南并未就筛查糖尿病的最佳血糖指标达成一致。这是因为有研究表明 HbA1c 低估了 PLWH 的血糖水平：在这篇综述中，我们总结了有关 HIV 与 2 型糖尿病关系的文献，以及随着时间的推移这种关系是如何变化的。我们还介绍了有关 PLWH HbA1c 差异的证据：我们认为，根据 HIV 血清状态来限制 HbA1c 的国际指南是没有依据的。根据目前的证据，我们建议 PLWH 应根据各国的具体指导意见，每年进行一次糖尿病筛查。最后，我们建议今后开展工作，阐明所有人群中 PLWH 2 型糖尿病的表型和自然病史。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

HIV Medicine 医学-传染病学

CiteScore

5.10

自引率

10.00%

发文量

167

审稿时长

6-12 weeks

期刊介绍： HIV Medicine aims to provide an alternative outlet for publication of international research papers in the field of HIV Medicine, embracing clinical, pharmocological, epidemiological, ethical, preclinical and in vitro studies. In addition, the journal will commission reviews and other feature articles. It will focus on evidence-based medicine as the mainstay of successful management of HIV and AIDS. The journal is specifically aimed at researchers and clinicians with responsibility for treating HIV seropositive patients.