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Less Diabetes Control in Non-adherence HIV Patients

by U.S. Medicine

August 5, 2014

DURHAM, NC – Poor adherence to antiretroviral therapy in veterans with human immunodeficiency virus (HIV) also is a good predictor of whether those same patients will achieve good control if they have diabetes.

That’s according to a study from the Durham, NC, VAMC, and Duke University which found that veterans with higher viral loads and those less adherent to antiretroviral therapy were more likely to have a higher hemoglobin A1c.1

The report was published recently in the International Journal of STD & AIDS.

“Antiretroviral therapy has decreased HIV-related mortality. However, the incidence of diabetes as a co-morbidity is increasing as HIV-positive patients age,” according to the authors, who explained that the purpose of the study was to assess the correlation between markers of HIV infection and diabetes and to determine the proportion of patients achieving an A1c goal less than 7%.

For the retrospective study, the researchers identified HIV-positive veterans with diabetes from 2007 to 2012. To be included in the review, patients were required to be on the same antiretroviral therapy and diabetes regimen for three months or longer.

Results indicated that, for each unit increase in log10 viral load, A1c increased 0.67 units (p = 0.0085). Only 38% of patients prescribed a protease inhibitor–based regimen vs. 56% of patients not on a protease inhibitor–based regimen achieved an A1c goal (p = 0.1864).

In addition, according to the study, patients on an insulin-based regimen and patients who were less adherent also were less likely to be at A1c goal (p = 0.018 and p = 0.0378, respectively).

“Patients with higher viral loads and patients that were less adherent to antiretroviral therapy were more likely to have a higher A1c, demonstrating that poor adherence to antiretroviral therapy leads to poor control of both disease states,” the authors concluded.

1 Davies ML, Johnson MD, Brown JN, Bryan WE, Townsend ML. Predictors of glycemic control among HIV-positive veterans with diabetes. Int J STD AIDS. 2014 May 14. pii: 0956462414535207. [Epub ahead of print] PubMed PMID: 24828555.

 


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