P321 A review of Type 2 diabetes and traditional risk factors in a large HIV+ cohort

Introduction As antiretroviral therapy (ART) has become more effective, life expectancy of HIV+ patients has increased to normal levels. Therefore, there is an increased risk of developing other age-associated chronic illnesses, including type 2 diabetes (T2DM). Some older ARTs and protease inhibitors may increase the risk of developing insulin resistance and diabetes. This study aimed to measure prevalence of diabetes within a large HIV+ cohort and describe potential risk factors for developing diabetes and factors predictive of a poor outcome. Methods A case note review of a 2390-person HIV+ cohort was conducted and people with diabetes were identified. Data on demographics, HIV duration, ART exposure, diabetic risk factors, and comorbidities were collected. Results 77 patients within the HIV+ cohort had T2DM. 63 were male (81.8%) and the median age was 59.0 (Interquartile range 54–67). Median time between HIV and DM diagnosis was 16.3 years (IQR 12.4–24.0). The median ART duration was 16.3 years, with a median of 14.5 years from antiretroviral commencement until diabetes diagnosis (IQR 9.8–21.9). 50 (64.9%) had been exposed to protease inhibitors. 17 (22.1%) had a nadir CD4 30 and 22 (28.6%) were from minority ethnic groups. Factors associated with diabetic complications included 27 (35.1%) had hyperlipidaemia and 33 (42.9%) had hypertension. Conclusion This study shows a prevalence of 3.2% of T2DM within a large HIV+ cohort, similar to the prevalence in the UK adult population. Traditional risk factors were common, and it seems a long duration of HIV infection and long exposure to ARV therapy, particularly protease inhibitors may increase risk. Factors associated with a poor prognosis were frequent, suggesting more aggressive management may be required in HIV+ patients with T2DM. Further research into the outcomes of such patients is needed.