A comparison of factors associated with prevalent diabetes mellitus among HIV-infected antiretroviral-naive individuals versus individuals in the National Health and Nutritional Examination Survey cohort

BACKGROUND: In the general population, diabetes mellitus (DM) is associated with age, minority race/ethnicity, and obesity. Among HIV-infected persons, antiretroviral therapy (ART) use and hepatitis C virus (HCV) infection have been associated with DM. This study examined DM prevalence and its predictors in ART-naive HIV-infected patients. METHODS: A cross-sectional analysis of ART-naive HIV-infected adults enrolled in 3 Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA) clinical trials versus adults enrolled in the National Health and Nutritional Examination Survey (NHANES). RESULTS: The prevalence of DM in the CPCRA clinical trials versus the NHANES was 3.3% versus 4.8%. The mean body mass index (BMI) was lower in the CPCRA trials versus the NHANES (25 kg/m vs. 28 kg/m). HCV was associated with DM only in univariate analyses in the CPCRA trials. In univariate and multivariate analyses, race/ethnicity, age, and BMI were associated with DM in both cohorts. Among women, age and BMI were associated with DM in both cohorts; race/ethnicity was associated with DM only in the NHANES. HCV was predictive of DM in blacks in the CPCRA trials (P = 0.004 before adjustment for multiple comparisons) but not in the full cohort. CONCLUSIONS: Our findings did not suggest an increased prevalence of DM in ART-naive HIV-infected patients. Although there was a trend toward increased prevalence of DM in HIV-HCV-coinfected patients, dominant risk factors associated with DM among ART-naive HIV-infected adults mirrored those of the general population.