@article{939b99e04d17444fb45943ddb4ecbe8a,
title = "Predicting the short-term risk of diabetes in HIV-positive patients: the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study.",
abstract = "Introduction: HIV-positive patients receiving combination antiretroviral therapy (cART) frequently experience metabolic complications such as dyslipidemia and insulin resistance, as well as lipodystrophy, increasing the risk of cardiovascular disease (CVD) and diabetes mellitus (DM). Rates of DM and other glucose-associated disorders among HIV-positive patients have been reported to range between 2 and 14%, and in an ageing HIV-positive population, the prevalence of DM is expected to continue to increase. This study aims to develop a model to predict the short-term (six-month) risk of DM in HIV-positive populations and to compare the existing models developed in the general population. Methods: All patients recruited to the Data Collection on Adverse events of Anti-HIV Drugs (D:A:D) study with follow-up data, without prior DM, myocardial infarction or other CVD events and with a complete DM risk factor profile were included. Conventional risk factors identified in the general population as well as key HIV-related factors were assessed using Poissonregression methods. Expected probabilities of DM events were also determined based on the Framingham Offspring Study DM equation. The D:A:D and Framingham equations were then assessed using an internal-external validation process; area under the receiver operating characteristic (AUROC) curve and predicted DM events were determined. Results: Of 33,308 patients, 16,632 (50%) patients were included, with 376 cases of new onset DM during 89,469 person-years(PY). Factors predictive of DM included higher glucose, body mass index (BMI) and triglyceride levels, and older age. Among HIV-related factors, recent CD4 counts ofB200 cells/mL and lipodystrophy were predictive of new onset DM. The mean performance of the D:A:D and Framingham equations yielded AUROC of 0.894 (95% CI: 0.849, 0.940) and 0.877 (95% CI: 0.823, 0.932), respectively. The Framingham equation over-predicted DM events compared to D:A:D for lower glucose and lower triglycerides, and for BMI levels below 25 kg/m2. Conclusions: The D:A:D equation performed well in predicting the short-term onset of DM in the validation dataset and for specific subgroups provided better estimates of DM risk than the Framingham. Copyright: {\textcopyright} 2012 Petoumenos K et al; licensee International AIDS Society.",
keywords = "Combination antiretroviral treatment, Diabetes mellitus, HIV, Risk equation, cholesterol, glucose, high density lipoprotein, triacylglycerol, anti human immunodeficiency virus agent, adult, age distribution, article, blood pressure, body mass, cardiovascular disease, CD4 lymphocyte count, cholesterol blood level, diabetes mellitus, female, follow up, heart infarction, human, Human immunodeficiency virus infected patient, Human immunodeficiency virus infection, lipodystrophy, major clinical study, male, population, priority journal, risk assessment, risk factor, sensitivity analysis, sex difference, validation process, virus load, chemically induced disorder, decision support system, drug toxicity, evaluation, highly active antiretroviral therapy, methodology, middle aged, prognosis, prospective study, Adult, Anti-HIV Agents, Antiretroviral Therapy, Highly Active, Decision Support Techniques, Diabetes Mellitus, Drug Toxicity, Female, HIV Infections, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Risk Assessment",
author = "K. Petoumenos and S.W. Worm and E. Fontas and R. Weber and {De Wit}, S. and M. Bruyand and P. Reiss and W. El-Sadr and {D'Arminio Monforte}, A. and N. Friis-Moller and J.D. Lundgren and M.G. Law and Ferran Torres",
note = "Cited By :51 Export Date: 17 February 2022 Correspondence Address: Petoumenos, K.; AHOD, , Sydney, NSW, 2052, Australia; email: kpetoumenos@kirby.unsw.edu.au Chemicals/CAS: cholesterol, 57-88-5; glucose, 50-99-7, 84778-64-3; Anti-HIV Agents Funding details: National Institute of Allergy and Infectious Diseases, NIAID, U01AI042170, U01AI046362, U01AI069907 References: Carr, A., Miller, J., Law, M., Cooper, D.A., A syndrome of lipoatrophy, lactic acidaemia and liver dysfunction associated with HIV nucleoside analogue therapy: Contribution to protease inhibitor-related lipodystrophy syndrome (2000) AIDS, 14, pp. F25-32; Carr, A., Samaras, K., Thorisdottir, A., Kaufmann, G.R., Chisholm, D.J., Cooper, D.A., Diagnosis, prediction, and natural course of HIV-1 protease-inhibitor- associated lipodystrophy, hyperlipidaemia, and diabetes mellitus: A cohort study (1999) Lancet, 353, pp. 2093-2099; Friis-Moller, N., Weber, R., Reiss, P., Thiebaut, R., Kirk, O., D'arminio Monforte, A., Cardiovascular disease risk factors in HIV patients-association with antiretroviral therapy. 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year = "2012",
month = jan,
doi = "10.7448/IAS.15.2.17426",
language = "English",
volume = "15",
journal = "Journal of the International AIDS Society",
issn = "1758-2652",
publisher = "International AIDS Society",
number = "2",
}
