Participant characteristics.

Suppressive antiretroviral treatment (ART) has resulted into prolonged survival of people with HIV (PWH) in Sub-Saharan Africa (SSA) with resultant increase in the incidence of non-communicable diseases (NCD), such as diabetes mellitus (DM). However, there is a lack of data on the effect of DM on HIV-related outcomes among PWH in this setting. The study aimed to compare HIV clinical outcomes (viral load suppression, retention in care, hospitalization, tuberculosis, and mortality) between PWH with DM and those without at two large HIV clinics in Kampala, Uganda. We conducted a matched retrospective cohort study using secondary data of PWH with DM and PWH without DM from January 2020 to June 2022. We used descriptive statistics to compare baseline characteristics and a chi-square test to compare the outcomes between the HIV/DM and HIV/no DM groups. The cohort consisted of 243 PWH diagnosed with DM matched with 1221 PWH without DM. We analysed 1,469 participant records: 1,009 (68.7%) from Mulago ISS clinic and 460 (31.3%) from Kisenyi HC IV. Most study participants (63.6%) were female, and the mean age was 43 years (standard deviation [SD] 11) and 38 years (SD 10) for those with DM and without DM, respectively. PWH with DM had significantly higher odds of hospitalization (adjusted odds ratio [AOR] 4.94; 95% CI: 1.93–12.66; p = 0.001) and were less likely to be retained in care (AOR 0.12, 95% CI: 0.07–0.20 p = <0.001). There were no differences in viral load suppression, TB diagnosis, and mortality between the PWH with DM and those without DM. These findings underscore the need for integrated management approaches that address both HIV and DM to improve health outcomes for this population. Future research could also explore the causes of hospitalization and non-retention among PWH and DM.

抑制性抗逆转录病毒治疗（Antiretroviral Therapy, ART）可延长撒哈拉以南非洲（Sub-Saharan Africa, SSA）艾滋病病毒感染者（People With HIV, PWH）的生存期，同时导致糖尿病（Diabetes Mellitus, DM）等非传染性疾病（Non-Communicable Diseases, NCD）的发病率升高。但目前该地区尚缺乏关于糖尿病对艾滋病病毒感染者艾滋病相关临床转归影响的相关数据。本研究旨在对比乌干达坎帕拉两家大型艾滋病诊疗机构中，合并糖尿病的艾滋病病毒感染者与未合并糖尿病者的艾滋病临床转归指标，包括病毒载量抑制、诊疗保留率、住院率、结核病发病及死亡率。本研究采用匹配性回顾性队列研究设计，使用2020年1月至2022年6月间的二级数据，纳入合并糖尿病的艾滋病病毒感染者与未合并糖尿病者作为研究对象。本研究采用描述性统计方法对比两组的基线特征，并通过卡方检验比较艾滋病合并糖尿病组与单纯艾滋病组的临床转归结局。本队列共纳入243例确诊糖尿病的艾滋病病毒感染者，匹配1221例未合并糖尿病的艾滋病病毒感染者，最终共分析1469份受试者记录：其中1009份（68.7%）来自穆拉戈ISS诊所，460份（31.3%）来自基塞尼HC IV诊所。多数研究参与者（63.6%）为女性；合并糖尿病组与未合并糖尿病组的平均年龄分别为43岁（标准差（Standard Deviation, SD）11）与38岁（标准差10）。合并糖尿病的艾滋病病毒感染者住院风险显著升高（校正比值比（Adjusted Odds Ratio, AOR）4.94；95%置信区间（Confidence Interval, CI）：1.93~12.66；P=0.001），且诊疗保留率更低（校正比值比0.12，95%置信区间：0.07~0.20，P<0.001）。两组在病毒载量抑制率、结核病诊断率及死亡率方面未观察到显著差异。本研究结果提示，需建立兼顾艾滋病与糖尿病的整合性管理方案，以改善该人群的健康转归。未来研究可进一步探讨艾滋病病毒感染者合并糖尿病时发生住院及诊疗保留率低下的潜在原因。