Международный журнал общественного здравоохранения и безопасности

Prevalence of Diabetes in HIV-infected Patients in the Medicine Department of Sikasso Hospital

Abstract

Garan Dabo, Dicko S.B., Nanko Doumbia, Koniba Diabate, Diarra I.M., Kassogue O., Yacouba L. Diallo and Daouda Kassoum Minta

Introduction: Diabetes during HIV infection remains frequent and the mechanism is complex, linked both to HIV and especially to Antiretroviral Drugs (ARVs). This HIV-diabetes comorbidity increases the cardiovascular risk. This is a major public health problem. In developing countries, very few studies have been carried out on the association between diabetes and HIV. The objective of this study was to evaluate the co-morbidity of diabetes and HIV in the Medicine Department of the Sikasso Hospital.

Patients and methods: This was a prospective, cross-sectional, descriptive study from March to August 2013. The study populations were patients over 15 years old followed up in external consultation for HIV infection. Diabetes screening was performed in all patients followed for HIV. Patients with HIV and diabetes co-morbidity were included out of a population of 324 HIV patients.

Results: We collected 18 patients among 786, i.e. a hospital frequency of 2.29%. The average age was 42 years and the sex ratio was 0.2 (3H/15F). HIV1 was involved in 94.45% of cases. And 50% (9/18 cases) of the patients were WHO stage 3, 11% had a CD4 count below 200 cells/ mm3. The patients were treated with ARVs in 83% of cases (15/18 cases). And the majority, 72% (13/15 cases) were on 2 nucleoside inhibitors combined with a non-nucleoside inhibitor. Diabetes was discovered after starting ARV treatment in 38.88% of cases. Type 2 diabetes was the most frequent with 77.78% (14/18 cases). The mode of discovery of diabetes was incidental in 7 cases (39%) and clinical in 11 cases (61%). Diabetes was treated with insulin in 9 cases (50%), oral antidiabetic drugs (OADs) in 7 cases (39%) and diet alone in 2 cases (11%). HIV1 viral load was performed in 7 patients on ARV treatment and 5 were undetectable. The vast majority of patients (95%, 16 cases) were in the care circuit and 5% of deaths were recorded.

Conclusion: HIV and antiretroviral treatment constitute an important risk factor for the development of diabetes cardiovascular disease.