Comparing the glucose metabolism derangement in human immunodeficiency virus infection patients on antiretroviral treatment with drug nave patients at Lagos State University Teaching Hospital

Abstract

People living with HIV and AIDS are exposed to the challenges of aging and diet related diseases due to prolonged survival by retroviral drugs. The presence of chronic inflammatory state and the metabolic effects of antiretroviral therapy are additional burden. This study was designed to determine the changes in glucose metabolism in HIV infection. This was a case-control study carried out at the adult HIV clinic. Consenting participants were grouped into four; those on nucleoside reverse transcriptase inhibitor/non-nucleoside reverse transcriptase inhibitor (NRTI/NNRTI) (group 1), those on NRTI/PI (group 2), those that were treatment naïve (group 3) and age and sex matched HIV negative controls (group 4). Questionnaires were used to assess the demography of participants. The weight and height of participants were done. Blood was collected for fasting blood sugar, 2 h post prandial glucose and CD4 count. The body mass index (BMI) was significantly lower in the participants on protease inhibitors. The control group had lower 2HPP glucose despite a higher FBS than the other groups that were HIV positive. Treatment naïve (group 3) tend to have higher 2-hour post-prandial blood sugar (2HPP) glucose tests (p= 0.04). The male HIV positive participants on PI also had significantly higher 2HPP glucose tests (p=0.01). The females had lower fasting blood sugar (FBS) and 2HPP glucose tests than the males. There were no correlations of glucose metabolism with CD4 count, age or BMI. The higher 2HPP glucose tests in participants who are treatment naïve may be explained by insulin resistance associated with chronic inflammatory state. It is therefore recommended that HAART be commenced early.