article · Cureus
Widespread access to antiretroviral therapy has prolonged the lives of people living with HIV, but it has also brought an increased burden of non-communicable conditions such as diabetes mellitus. To understand this issue in sub-Saharan Africa, a cross-sectional study evaluated 409 patients attending an HIV care clinic at Muhimbili National Hospital in Dar es Salaam, Tanzania. The investigation recorded demographic details, medical histories, body mass index, CD4 counts, and fasting plasma glucose levels. Diabetes was identified in 3.7 percent of the cohort, in which most participants were virally suppressed and had preserved immune function. Factors independently linked to diabetes included older age, absence of a family history of diabetes, and a CD4 count below 200 cells per microlitre. Routine glucose screening and metabolic counselling remain essential components of ongoing care programmes.
As modern antiretroviral therapy helps people living with HIV survive into older age, chronic metabolic conditions like diabetes present new clinical challenges. Demonstrating the prevalence and predictors of diabetes within specialised clinics highlights the necessity of integrating routine metabolic screening and health counselling into regular HIV treatment services, ensuring long-term complications are managed alongside viral suppression.
The abstract does not indicate a direct commercial application or technology pathway, as it presents clinical epidemiological research intended to inform routine blood glucose screening and patient counselling within healthcare facilities.
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Background With the widespread use of antiretroviral therapy (ART), people living with HIV (PLWHIV) are experiencing an extended life expectancy and a rising burden of non-communicable diseases, including diabetes mellitus. The interaction between HIV infection, long-term ART exposure, and metabolic alterations remains poorly understood, particularly in sub-Saharan Africa. This study aimed to determine the prevalence of diabetes mellitus and identify associated risk factors among PLWHIV receiving ART in Tanzania. Methodology A cross-sectional study was conducted among 409 PLWHIV attending the Muhimbili National Hospital HIV Care and Treatment Clinic in Dar es Salaam, Tanzania. Data on sociodemographic, clinical, and laboratory characteristics were collected using a structured questionnaire and patient medical records. Variables included age, gender, CD4 count, body mass index, ART regimen and duration, and family history of diabetes. Diabetes mellitus was defined according to the WHO criteria as fasting plasma glucose ≥7.0 mmol/L or documented use of glucose-lowering medication. Logistic regression analysis was used to identify factors independently associated with diabetes, and statistical significance was set at a p-value <0.05. Results The mean age of the participants was 44.7 years, and 65.3% (n = 267) were female. The prevalence of diabetes mellitus was 3.7% (n = 15). Independent predictors of diabetes included older age (adjusted odds ratio (AOR) = 1.14; 95% confidence interval (CI) = 1.05-1.25; p = 0.003), absence of a family history of diabetes (AOR = 0.07; 95% CI = 0.02-0.27; p < 0.001), and CD4 count <200 cells/µL (AOR = 0.14; 95% CI = 0.02-0.88; p = 0.036). The majority of participants (89.4%) had CD4 count ≥200 cells/µL, and 98.3% achieved viral load suppression. Conclusions Diabetes mellitus was observed in 3.7% of PLHIV receiving ART in this clinic cohort. These findings support the need to maintain routine opportunistic blood glucose screening and reinforce metabolic health counseling within HIV care. However, we cannot infer excess risk compared to the general Tanzanian population because no age-standardized comparison was performed, and diagnostic ascertainment was limited to fasting plasma glucose.
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DOI: 10.7759/cureus.96800
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