Human immunodeficiency virus infection and diabetes mellitus, their coexistence among patients' in Dar es Salaam: a crossectional study

Background: There have been reports of increased occurrences of diabetes mellitus and hyper glycaemia in patients infected with HIV; this has largely been attributed to the use of Highly Active Antiretroviral Therapy, especially the use of protease inhibitors. Other medications used in HIV patients that have been reported to be associated with hyperglycemia include drugs used for the treatment of opportunistic infections such as pentamidine. Some opportunistic infections of viral origin commonly found in HIV patients, have previously been reported to be possible causes of diabetes mellitus. Objectives: To determine the coexistence of HIV infection and Diabetes Mellitus among patients in Dar e salaam Methodology: Study sites: The study was carried out at Diabetic and HIV clinics at Muhimbili National Hospital, Mwananyamala, Temeke, Ilala and Hindu Mandar Hospital all in Dare es salaam Tanzania. Study Subjects: Male and Female patients aged 18-75 years attending Diabetic and HIV clinics. Procedure: A medical history-was taken and physical examination done. Pre and posttest HIV counseling were done for consenting diabetic patients. Venous blood for HIV testing, CD4/CD8, blood glucose, full blood picture and ESR were taken. Those found to be diabetic or HIV infected was referred to the respective clinics at Muhimbili National Hospital for further management. Analysis: Data was analysed to determine the prevalence of HIV and diabetes among diabetic and HIV patients respectively. Results: The prevalence of HIV among diabetes patients was found to be 13.79%, while prevalence diabetes among HIV infected individuals was 13.8%. Clinical characteristics were frequent in HIV positive patients with diabetes versus those without diabetes. However diabetes patients found to be HIV positive were more symptomatic than those without HIV. Mean blood glucose, cholesterol, triglyceride were significantly elevated in HIV positive patients on antiretroviral than those who were not. Conclusion: Carbohydrate metabolism abnormalities leading to hyperglycaemia and diabetes as well as, lipid abnormalities are present in HIV infected patients particularly those on ARV therapy and this has important clinical implications in the long term management of HIV patients with ARVs both in treatment and monitoring of the complications of ARV therapy.