Diabetes negatively impacts the ten-year survival rates of people living with HIV

Int J STD AIDS. 2019 Sep;30(10):991-998. doi: 10.1177/0956462419857005. Epub 2019 Jul 23.

Abstract

People living with HIV (PLWH) are dying of non-AIDS associated conditions, including type 2 diabetes and chronic kidney disease (CKD), but the impact of diabetes and CKD on HIV survival rates is unknown. The purpose of this retrospective longitudinal study was to investigate the impact of diabetes and CKD on the survival rates of PLWH, using a secondary analysis of data from the Centers for AIDS Research Network of Integrated Clinical Systems (N=10,043 PLWH). The sample was divided into three comorbidity groups: HIV alone, HIV with diabetes, and HIV with diabetes and CKD. Kaplan–Meier analysis was used to examine survival rates; Cox regression was used to assess relationships between variables. Overall mean survival time was 19.7 years (95% CI, 19.57–19.8). For HIV alone (n=8266), the mortality rate was 3.6%; for HIV with diabetes (n=1720), mortality was almost three times higher (12.0%); and for HIV with diabetes and CKD (n=57), survival was less than three times higher (36.8%) than for HIV alone. Knowing that diabetes mellitus decreases survival rates, healthcare providers need to halt or delay the onset of type 2 diabetes by more aggressively assessing for prediabetes and treating it.

Keywords: Antiretroviral therapy; HIV; chronic kidney disease; comorbid conditions; diabetes; survival rates.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Comorbidity
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Female
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV Infections / mortality*
  • Humans
  • Kaplan-Meier Estimate
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Renal Insufficiency, Chronic / diagnosis
  • Renal Insufficiency, Chronic / epidemiology*
  • Retrospective Studies
  • Survival Rate
  • United States / epidemiology