Diabetes, mortality and glucose monitoring rates in the TREAT Asia HIV Observational Database Low Intensity Transfer (TAHOD-LITE) study

the TREAT Asia HIV Observational Database (TAHOD) of the International Epidemiology Databases to Evaluate AIDS (IeDEA) Asia-Pacific group

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9 Citations (Scopus)


Objectives: Diabetes is a growing cause of morbidity and mortality in people living with HIV (PLHIV) receiving antiretroviral therapy (ART). We investigated the association between fasting plasma glucose (FPG) levels and mortality, and factors associated with FPG monitoring rates in Asia. Methods: Patients from the Therapeutics Research, Education, and AIDS Training in Asia (TREAT Asia) HIV Observational Database Low Intensity Transfer (TAHOD-LITE) cohort were included in the present study if they had initiated ART. Competing risk and Poisson regression were used to analyse the association between FPG and mortality, and assess risk factors for FPG monitoring rates, respectively. FPG was categorized as diabetes (FPG ≥ 7.0 mmol/L), prediabetes (FPG 5.6–6.9 mmol/L) and normal FPG (FPG ' 5.6 mmol/L). Results: In total, 33 232 patients were included in the analysis. Throughout follow-up, 59% had no FPG test available. The incidence rate for diabetes was 13.7 per 1000 person-years in the 4649 patients with normal FPG at ART initiation. Prediabetes [sub-hazard ratio (sHR) 1.32; 95% confidence interval (CI) 1.07–1.64] and diabetes (sHR 1.90; 95% CI 1.52–2.38) were associated with mortality compared to those with normal FPG. FPG monitoring increased from 0.34 to 0.78 tests per person-year from 2012 to 2016 (P ' 0.001). Male sex [incidence rate ratio (IRR) 1.08; 95% CI 1.03–1.12], age ' 50 years (IRR 1.14; 95% CI 1.09–1.19) compared to ≤ 40 years, and CD4 count ≥ 500 cells/μL (IRR 1.04; 95% CI 1.00–1.09) compared to ' 200 cells/μL were associated with increased FPG monitoring. Conclusions: Diabetes and prediabetes were associated with mortality. FPG monitoring increased over time; however, less than half of our cohort had been tested. Greater resources should be allocated to FPG monitoring for early diabetic treatment and intervention and to optimize survival.

Original languageEnglish
Pages (from-to)615-623
Number of pages9
JournalHIV Medicine
Issue number9
Publication statusPublished - 2019 Oct 1

Bibliographical note

Funding Information:
The members of the TAHOD of IeDEA Asia-Pacific group are as follows: P. S. Ly and V. Khol, National Center for HIV/AIDS, Dermatology & STDs, Phnom Penh, Cambodia; M. P. Lee, P. C. K. Li, W. Lam and Y. T. Chan, Queen Elizabeth Hospital, Hong Kong SAR; N. Kumarasamy, S. Saghayam and C. Ezhilarasi, Chennai Antiviral Research and Treatment Clinical Research Site (CART CRS), YRGCARE Medical Centre, VHS, Chennai, India; S. Pujari, K. Joshi, S. Gaikwad and A. Chitalikar, Institute of Infectious Diseases, Pune, India; T. P. Merati, D. N. Wirawan and F. Yuliana, Faculty of Medicine Udayana University & Sanglah Hospital, Bali, Indonesia; O. T. Ng, P. L. Lim, L. S. Lee and Z. Ferdous, Tan Tock Seng Hospital, Singapore; J. Y. Choi, S. Na and J. M. Kim, Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea; W. W. Wong, W. W. Ku and P. C. Wu, Taipei Veterans General Hospital, Taipei, Taiwan; C. D. Do, A. V. Ngo and L. T. Nguyen, Bach Mai Hospital, Hanoi, Vietnam; K. V. Nguyen, H. V. Bui, D. T. H. Nguyen and D. T. Nguyen, National Hospital for Tropical Diseases, Hanoi, Vietnam; A. H. Sohn, J. L. Ross and B. Petersen, TREAT Asia, amfAR – The Foundation for AIDS Research, Bangkok, Thailand; R. Bijker, A. Jiamsakul, D. Rupasinghe and M. G. Law, The Kirby Institute, UNSW Sydney, Sydney, Australia. Conflicts of interest: There are no conflicts of interest to declare. Financial disclosure: The TREAT Asia HIV Observational Database Low Intensity Transfer study is an initiative of TREAT Asia, a programme of amfAR, The Foundation for AIDS Research, with support from the US National Institutes of Health's National Institute of Allergy and Infectious Diseases, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Cancer Institute, the National Institute of Mental Health, and the National Institute on Drug Abuse, as part of the International Epidemiology Databases to Evaluate AIDS (IeDEA; U01AI069907). The Kirby Institute is funded by the Australian Government Department of Health and Ageing, and is affiliated with the Faculty of Medicine, UNSW Sydney. The PhD of RB has been supported through an Australian Government Research Training Program Scholarship. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any of the governments or institutions mentioned above.

Publisher Copyright:
© 2019 British HIV Association

All Science Journal Classification (ASJC) codes

  • Health Policy
  • Infectious Diseases
  • Pharmacology (medical)


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