Nakalega Rita, Semitala Fred Collins, Mutebi Edrisa Ibrahim, Mawanda Denis, Lukyamuzi Zubair, Menge Robert, Babirye Juliet Allen, Namiiro Sharon Miriam, Kugonza Cleopatra Daphne, Mukiza Nelson, Mujugira Andrew
Makerere University-Johns Hopkins University (MU-JHU) Research Collaboration, Kampala, Uganda.
Makerere University, Joint AIDS Program (MJAP), Kampala, Uganda.
PLOS Glob Public Health. 2025 Jan 16;5(1):e0003922. doi: 10.1371/journal.pgph.0003922. eCollection 2025.
Suppressive antiretroviral treatment (ART) has resulted into prolonged survival of people with HIV (PWH) in Sub-Saharan Africa (SSA) with resultant increase in the incidence of non-communicable diseases (NCD), such as diabetes mellitus (DM). However, there is a lack of data on the effect of DM on HIV-related outcomes among PWH in this setting. The study aimed to compare HIV clinical outcomes (viral load suppression, retention in care, hospitalization, tuberculosis, and mortality) between PWH with DM and those without at two large HIV clinics in Kampala, Uganda. We conducted a matched retrospective cohort study using secondary data of PWH with DM and PWH without DM from January 2020 to June 2022. We used descriptive statistics to compare baseline characteristics and a chi-square test to compare the outcomes between the HIV/DM and HIV/no DM groups. The cohort consisted of 243 PWH diagnosed with DM matched with 1221 PWH without DM. We analysed 1,469 participant records: 1,009 (68.7%) from Mulago ISS clinic and 460 (31.3%) from Kisenyi HC IV. Most study participants (63.6%) were female, and the mean age was 43 years (standard deviation [SD] 11) and 38 years (SD 10) for those with DM and without DM, respectively. PWH with DM had significantly higher odds of hospitalization (adjusted odds ratio [AOR] 4.94; 95% CI: 1.93-12.66; p = 0.001) and were less likely to be retained in care (AOR 0.12, 95% CI: 0.07-0.20 p = <0.001). There were no differences in viral load suppression, TB diagnosis, and mortality between the PWH with DM and those without DM. These findings underscore the need for integrated management approaches that address both HIV and DM to improve health outcomes for this population. Future research could also explore the causes of hospitalization and non-retention among PWH and DM.
在撒哈拉以南非洲地区（SSA），抗逆转录病毒抑制治疗（ART）已使艾滋病毒感染者（PWH）的生存期延长，导致非传染性疾病（NCD）发病率上升，如糖尿病（DM）。然而，在这种情况下，缺乏关于糖尿病对艾滋病毒感染者艾滋病毒相关结局影响的数据。该研究旨在比较乌干达坎帕拉两家大型艾滋病毒诊所中患糖尿病的艾滋病毒感染者与未患糖尿病的艾滋病毒感染者之间的艾滋病毒临床结局（病毒载量抑制、治疗留存率、住院情况、结核病和死亡率）。我们利用2020年1月至2022年6月期间患糖尿病的艾滋病毒感染者和未患糖尿病的艾滋病毒感染者的二次数据进行了一项匹配回顾性队列研究。我们使用描述性统计来比较基线特征，并使用卡方检验来比较艾滋病毒/糖尿病组和艾滋病毒/无糖尿病组之间的结局。该队列包括243名被诊断患有糖尿病的艾滋病毒感染者，与1221名未患糖尿病的艾滋病毒感染者相匹配。我们分析了1469份参与者记录：1009份（68.7%）来自穆拉戈国际疾病分类诊所，460份（31.3%）来自基森伊第四保健中心。大多数研究参与者（63.6%）为女性，患糖尿病者的平均年龄为43岁（标准差[SD]11），未患糖尿病者的平均年龄为38岁（SD 10）。患糖尿病的艾滋病毒感染者住院几率显著更高（调整优势比[AOR]4.94；95%置信区间：1.93 - 12.66；p = 0.001），且治疗留存率较低（AOR 0.12，95%置信区间：0.07 - 0.20，p = <0.001）。患糖尿病的艾滋病毒感染者与未患糖尿病的艾滋病毒感染者在病毒载量抑制、结核病诊断和死亡率方面没有差异。这些发现强调了需要采取综合管理方法来同时应对艾滋病毒和糖尿病，以改善该人群的健康结局。未来的研究还可以探索艾滋病毒感染者和糖尿病患者住院及治疗留存率低的原因。
