ความชุกและปัจจัยทางคลินิกที่สัมพันธ์กับภาวะน้ำตาลในเลือดสูงในกลุ่มผู้ติดเชื้อเอชไอวีไทย

Nopphadet Manoowong; Chareeporn  Akekawatchai

Authors

Nopphadet Manoowong Samutsakhon Hospital
Chareeporn Akekawatchai Thammasat University Research Unit in Diagnostic Molecular Biology of Chronic Diseases Related to Cancer, Pathum Thani Province, Thailand

Keywords:

Clinical factor, hyperglycemia, people living with HIV, prevalence

Abstract

Hyperglycemia is one of the common complications in people living with HIV (PLWH) undergoing anti-retroviral therapy (ART), potentially leading to various diseases, especially diabetes. However, prevalence and factors involved with the disease in PLWH undergoing ART are still not well-defined. This study aimed to examine the prevalence of hyperglycemia and its associated clinical factors in Thai PLWH. A cross-sectional study was conducted in 236 Thai PLWH attending Samutsakhon Hospital between September 2021 and November 2021. Clinical and laboratory data were collected from medical records and analyzed by descriptive statistics, the Chi-square test, and logistic regression analysis. In this study, the prevalence of hyperglycemia, classified as diabetes (a fasting blood glucose (FBS) level ≥ 126 mg/dL) and prediabetes (a FBS level ≥ 100 mg/dL), were 10.6% and 50.8%, respectively. The analysis indicated that anti-retroviral drug regimens, CD4⁺ cell count, and triglyceride levels were significantly associated with hyperglycemia. Ages, 41-50 years and older than 50 years, were risk factors, and being female was a protective factor for hyperglycemia, defined as FBS ≥ 100 mg/dL. The data generated from this study suggest the importance of screening and monitoring blood sugar levels in PLWH with risk factors, such as being male and older than 40 years, to support the treatment and care of PLWH undergoing ART.

References

UNAIDS [homepage on the Internet]. Fact sheet - World AIDS day 2023. 2024 [cited 2025 March 1]. Available from: https://www.unaids.org/en/resources/fact-sheet.

UNAIDS [homepage on the Internet]. Country factsheets - Thailand 2023. 2024 [cited 2025 March 1]. Available from: https://www.unaids.org/en/regionscountries/countries/thailand.

Division of AIDS and sexually transmitted infections department of disease control. Thailand national guidelines on HIV/AIDS treatment and prevention 2021/2022. Nonthaburi: Aksara graphic & design; 2022. (in Thai)

Zicari S, Sessa L, Cotugno N, et al. Immune activation, inflammation, and non-AIDS co-morbidities in HIV-infected patients under long-term ART. Viruses 2019; 11: 200.

Deeks SG, Lewin SR, Havlir DV. The end of AIDS: HIV infection as a chronic disease. Lancet. 2013; 382: 1525-33.

Noubissi EC, Katte JC, Sobngwi E. Diabetes and HIV. Curr Diab Rep 2018; 18: 125.

Borkowska T, Chkhartishvili N, Karkashadze E, et al. The prevalence of hyperglycemia and its impact on mortality among people living with HIV in Georgia. PLoS One 2022; 17: e0276749.

Paengsai N, Jourdain G, Chaiwarith R, et al. Incidence and clinical outcomes of diabetes mellitus in HIV-infected adults in Thailand: a retrospective cohort study. BMC Public Health 2018; 18: 1079.

Shen Y, Wang Z, Liu L, Zhang R, Zheng Y, Lu H. Prevalence of hyperglycemia among adults with newly diagnosed HIV/AIDS in China. BMC Infect Dis 2013; 13: 79.

Lartey M, Kenu E, Ganu V, et al. Incidence of type 2 diabetes mellitus in persons living with HIV initiated on dolutegravir-based antiretroviral regimen in Ghana: an observational longitudinal study. J Health Popul Nutr 2024; 43: 199.

Putcharoen O, Wattanachanya L, Sophonphan J, et al. New-onset diabetes in HIV-treated adults: predictors, long-term renal and cardiovascular outcomes. Aids 2017; 31: 1535-43.

Byereta LH, Olum R, Mutebi EI, et al. Prevalence and factors associated with hyperglycemia among persons living with HIV/AIDS on dolutegravir-based antiretroviral therapy in Uganda. Ther Adv Infect Dis 2024; 11: 20499361241272630.

Dhitinanmuang W, Anukrua P. Factors associated with new onset type 2 diabetes mellitus factors associated with new onset type 2 diabetes mellitus in HIV-infected patients at HIV clinic Ratchaburi hospital. Region 4-5 Medical Journal 2023; 42: 471-82.

World Health Organization [homepage on the Internet]. WHO guidelines on hepatitis B and C testing 2017 [cited 2025 March, 16]. Available from: https://www.ncbi.nlm.nih.gov/books/

NBK442272/.

Pappan N, Awosika AO, Rehman A. Dyslipidemia. [Updated 2024 Mar 4]. In: StatPearls [book section on Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560891/.

Diabetes Association of Thailand under the Patronage of Her Royal Highness Princess Maha Chakri Sirindhorn and The Endocrine Society of Thailand. Clinical practice guideline for diabetes 2023. 2nd ed. Bangkok: Sri muang printing; 2024. (in Thai)

American Diabetes Association. Standards of medical care in diabetes--2013. Diabetes care. 2013; 36: S11-66.

Mohan J, Ghazi T, Chuturgoon AA. A critical review of the biochemical mechanisms and epigenetic modifications in hiv- and antiretroviral-induced metabolic syndrome. Int J Mol Sci 2021; 22: 12020.

Rwegerera GM, Shailemo DHP, Pina Rivera Y, et al. Metabolic control and determinants among HIV-infected type 2 diabetes mellitus patients attending a tertiary clinic in botswana. Diabetes Metab Syndr Obes 2021; 14: 85-97.

Yan H, Yang W, Zhou F, et al. Estrogen improves insulin sensitivity and suppresses gluconeogenesis via the transcription factor foxo1. Diabetes 2019; 68: 291-304.