Prediabetes and diabetes among HIV-infected adults in Cameroon

Background: Human immunodeficiency virus (HIV) and certain antiretrovirals are associated with diabetes. Few studies have examined the prevalence of and factors associated with diabetes among HIV-infected individuals on combination antiretroviral therapy (cART) in sub-Saharan Africa; some report prevalence estimates between 3.5–26.5% for diabetes in Cameroon and 20.2–43.5% for prediabetes in sub-Saharan Africa. Methods: In a cross-sectional study, HIV-infected individuals (16–65 years old) were screened for diabetes using haemoglobin A_1c (HbA_1c). We further categorized HbA_1C as normoglycemia (HbA_1c < 5.7%), prediabetes (HbA_1c 5.7–6.4%) or diabetes (HbA_1c ≥ 6.5%). Dysglycemia was defined as HbA_1c ≥ 5.7%. Logistic regression modelling was used to assess factors associated with having dysglycemia. Results: Of 500 participants, 363 (72.6%) were female. Median age was 42.5 years [interquartile range (IQR): 36.5–49.5]. Nineteen patients (3.8%) had diabetes and 170 patients (34%) were classified as having prediabetes. One hundred nine (22%) had a CD4+ count <200 cells/mm³, and 464 (93%) had received >28 days of ART at time of screening. Median abdominal circumference for women was 79.5 cm (IQR: 75.5–85.3) and for men, 86.5 cm (IQR: 81.7–90.5). Adjusting for age, sex, socio-economic status, CD4 cell count, being on cART >28 days, body mass index, hypertension, history of hypertension, abdominal circumference and duration of HIV infection, larger abdominal circumference was associated with higher prevalence of prediabetes or diabetes (adjusted odds ratio = 1.07, 95% confidence interval: 1.03–1.11), while being on cART (adjusted odds ratio = 0.46, confidence interval: 0.22–0.99) was associated with lower prevalence. Conclusions: There was a high prevalence of dysglycemia among Cameroonian HIV-infected adults. Larger abdominal circumference was associated with higher prevalence, while cART was associated with lower prevalence.