Park Jungmin, Zuñiga Julie A, García Alexandra A
1 School of Nursing, CHA University, Pocheon, Korea.
2 School of Nursing, The University of Texas at Austin, Austin, TX, USA.
Int J STD AIDS. 2019 Sep;30(10):991-998. doi: 10.1177/0956462419857005. Epub 2019 Jul 23.
People living with HIV (PLWH) are dying of non-AIDS associated conditions, including type 2 diabetes and chronic kidney disease (CKD), but the impact of diabetes and CKD on HIV survival rates is unknown. The purpose of this retrospective longitudinal study was to investigate the impact of diabetes and CKD on the survival rates of PLWH, using a secondary analysis of data from the Centers for AIDS Research Network of Integrated Clinical Systems (=10,043 PLWH). The sample was divided into three comorbidity groups: HIV alone, HIV with diabetes, and HIV with diabetes and CKD. Kaplan–Meier analysis was used to examine survival rates; Cox regression was used to assess relationships between variables. Overall mean survival time was 19.7 years (95% CI, 19.57–19.8). For HIV alone (=8266), the mortality rate was 3.6%; for HIV with diabetes (=1720), mortality was almost three times higher (12.0%); and for HIV with diabetes and CKD (=57), survival was less than three times higher (36.8%) than for HIV alone. Knowing that diabetes mellitus decreases survival rates, healthcare providers need to halt or delay the onset of type 2 diabetes by more aggressively assessing for prediabetes and treating it.
感染艾滋病毒的人(PLWH)正死于与艾滋病无关的疾病,包括2型糖尿病和慢性肾脏病(CKD),但糖尿病和慢性肾脏病对艾滋病毒存活率的影响尚不清楚。这项回顾性纵向研究的目的是通过对综合临床系统艾滋病研究网络(=10,043名PLWH)的数据进行二次分析,调查糖尿病和慢性肾脏病对PLWH存活率的影响。样本被分为三个合并症组:仅感染艾滋病毒、感染艾滋病毒合并糖尿病、感染艾滋病毒合并糖尿病和慢性肾脏病。采用Kaplan-Meier分析来检验存活率;采用Cox回归来评估变量之间的关系。总体平均生存时间为19.7年(95%CI,19.57-19.8)。仅感染艾滋病毒组(=8266)的死亡率为3.6%;感染艾滋病毒合并糖尿病组(=1720)的死亡率几乎高出三倍(12.0%);感染艾滋病毒合并糖尿病和慢性肾脏病组(=57)的死亡率比仅感染艾滋病毒组高出不到三倍(36.8%)。鉴于糖尿病会降低存活率,医疗服务提供者需要通过更积极地评估糖尿病前期并进行治疗,来阻止或延缓2型糖尿病的发病。