Abstract P227: Higher HIV Viral Load in HIV Positive Patients with Hyperglycemia in Miami, Florida
Introduction: Hyperglycemia is associated with insulin resistance, metabolic syndrome and depressed innate immunity, but it is also induced by trauma, infections and stress. Combined antiretroviral therapy (cART) is necessary for the control of HIV viral load and delayed disease progression, but hyperglycemia has been identified as one of the side-effects of some of the antiretroviral medications, namely the protease inhibitors. However, further research is needed to identify possible sources of hyperglycemia in HIV infection.
Hypothesis: Hyperglycemia is directly associated with HIV disease progression measured by CD4 cell count and viral load, and with the use of protease inhibitors (PI).
Methods: Secondary analysis was conducted on the de-identified observational database from a subset (n=270 participants) of the Miami Adult Studies in HIV (MASH) cohort. The variables analyzed were fasting glucose levels, receiving cART, use of protease inhibitors (PIs), age, gender, parameters of disease progression (CD4 cell count and HIV viral load), and anthropometries (height, weight, waist/hip circumference) at baseline. Patients were categorized into the hyperglycemic group (fasting blood glucose ≥110mg/dL) and normal fasting glucose group (<110mg/dL). Linear and logistic regressions were used to analyze the data.
Results: Of the total of 270 HIV infected participants, 32 participants had hyperglycemia. There were no significant differences in the use of protease inhibitors between the participants who had hyperglycemia and those who had normal glucose levels (P=0.980). In regression models, hyperglycemia was strongly associated with HIV viral load (Beta= 5.02, SE=4.6, P=0.0082) when compared to the participants with normal blood glucose levels. This relationship remained significant after controlling for age, gender, CD4 cell counts and albumin levels (P=0.0078). There were no significant differences between the two groups in age, gender, ethnicity, BMI, and CD4 cell count.
Conclusions: The relationship between higher HIV viral load and hyperglycemia, although novel, is not surprising, because hyperglycemia has been found in several types of acute responses to critical illnesses. Implementing interventions to improve HIV viral control and prevent and treat hyperglycemia in this population is critical for the long-term management of the disease.
Author Disclosures: A. Sneij: None. A. Campa: None. E. Veledar: None. S.S. Martinez: None. Y. Li: None. M.K. Baum: None.
- © 2015 by American Heart Association, Inc.