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Diabetes and HIV

  • Other Forms of Diabetes and Its Complications (JJ Nolan and H Thabit, Section Editors)
  • Published:
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Abstract

Purpose of Review

This review seeks to address the epidemiology and pathophysiological basis of the interaction between HIV infection and diabetes and the implication for treatment. Its importance stems from the current context of the growing burden of both conditions and the possible mechanisms of interactions that may exist but not yet sufficiently examined.

Recent Findings

HIV infection is associated with increased risk of insulin resistance, and ART is associated with metabolic derangement and the occurrence of type 2 diabetes. The increasing survival among people with HIV infection in developing countries is paralleled by a growing burden of chronic non-communicable diseases (NCDs) especially cardiovascular diseases and diabetes mellitus. The prevalence of diabetes mellitus is higher in HIV-positive persons compared to the general population, and especially those with associated hepatitis C virus (HCV) co-infection. Antiretroviral therapy (ART) during chronic HIV infection is the most incriminated risk factor for the development of diabetes mellitus through diverse mechanisms depending on the ART leading to insulin resistance and increased inflammatory status.

Summary

A staggering 629 million of people 20–79 years are projected to have diabetes by 2045 while the world will soon enter the fourth decade of the HIV infection. Classical risk factors for diabetes such as physical inactivity and unhealthy diet may not solely explain the current trends, suggesting the role of novel risk factors including infections/inflammation. HIV and its treatment have been identified as potential contributors. Co-infections frequently observed during HIV infection also significantly influence both the epidemiological and pathophysiological of the link between HIV and diabetes. Although the relative contribution of each risk factor has not yet been quantified, several lines of evidence suggest that ART is a major contributor to hyperglycemia in HIV infection. ARTs have also led to an increase in metabolic dysfunction, including insulin resistance syndromes, dyslipidemia, and lipodystrophy. The association between ARTs and the risk of developing diabetes therefore calls for a careful choice of medication and evaluation of the risk of developing diabetes.

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Authors and Affiliations

  1. Department of Biochemistry, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon

    Emile Camille Noubissi

  2. Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon

    Jean-Claude Katte

  3. National Obesity Center and Endocrine and Metabolic Diseases Unit, Yaoundé Central Hospital, Yaoundé, Cameroon

    Eugene Sobngwi

  4. Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon

    Eugene Sobngwi

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  1. Emile Camille Noubissi
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  2. Jean-Claude Katte
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  3. Eugene Sobngwi
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Correspondence to Eugene Sobngwi.

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Emile Camille Noubissi, Jean-Claude Katte, and Eugene Sobngwi declare that they have no conflict of interest.

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This article is part of the Topical Collection on Other Forms of Diabetes and Its Complications

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Noubissi, E.C., Katte, JC. & Sobngwi, E. Diabetes and HIV. Curr Diab Rep 18, 125 (2018). https://doi.org/10.1007/s11892-018-1076-3

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