Effects of diabetes mellitus on virologic and immunologic outcomes of patients on first line antiretroviral therapy in a military population in South Africa
Background: Africa faces a dual burden of chronic non-communicable diseases and infectious diseases, such as Diabetes Mellitus (DM) and Acquired Immune Deficiency Syndrome (AIDS). The alarming rate of Human Immunodeficiency Virus (HIV) infection led South Africa to become the largest antiretroviral therapy (ART) roll out programme, leading to multiple co-morbidities. Although good results from HIV control were obtained through ART, the area of HIV and DM co-morbidity concerning virologic and immunology, is underresearched. Research design and methods: The study included the duration of survival for HIV patients with DM (HIV DM) and for those with HIV but without DM (HIV Non-DM), through examining their immunologic and virologic status. Their Viral Load (VL) defines virologic status and CD4 cell count defines immunological status in both groups over a 12-month period in South African military setting, comprising six different antiretroviral (ARV) roll out sites. The relationship between VL and CD4 cell counts in terms of virological failure (VF) and immunological failure (IF) respectively; of HIV DM and HIV Non-DM during a 12-month period was examined using Poisson and Cox regression models. xvi Results: Amongst 1380 patients, 47 indicated HIV and DM while 1333 indicated HIV but were Non-DM. The study sample was predominantly male, with the majority from a rural area with varying educational levels, ranging from tertiary level, secondary, high school and illiterate population. In the Cox regression of VL analysis, DM and Non-DM do not differ significantly (P value = 0.986) after adjusting for the significant covariates, such as Haemoglobin (Hb) (P=0.006), being female (P
HIV diabetic mellitus, HIV non-Diabetic Mellitus, Diabetes Mellitus, virologic failure, immunologic failure.
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