OBJECTIVE Type 2 diabetes (T2D) is reported to be more common in people living with HIV (PLWH). Clinical guidelines recommend screening for diabetes in PLWH, but there is no agreed method due to studies reporting HbA1c is falsely low in PLWH. These studies were performed in the early HIV era when participants were taking older preparations of antiretroviral therapy that are rarely used today. We aimed to investigate whether HIV serostatus influences HbA1c. RESEARCH DESIGNS AND METHODS We conducted a prospective cohort study of PLWH and age- and sex-matched HIV-negative participants who were purposely recruited from clinics in Brighton, U.K. Each participant wore a Dexcom G6 continuous glucose monitor (CGM) for up to 10 days, had glucose measured during an oral glucose tolerance test, and fructosamine and paired HbA1c were measured. We performed regression analysis to assess the influence of HIV on HbA1c and used a separate model for CGM glucose, venous glucose, and fructosamine. In addition, we included predictor variables used in previous studies that explored HbA1c discrepancy. RESULTS We recruited 60 PLWH (90% men, 50% with T2D, mean ± SD age 57 ± 10.7 years, 100% undetectable viral load) and 48 people without HIV (92% men, 30% with T2D, mean age 57.7 ± 8.9 years). We found that HIV serostatus did not have a significant influence on HbA1c within the regression models. CONCLUSIONS We performed a comprehensive assessment of glycemia to assess whether HIV serostatus influences HbA1c. We did not find any strong evidence that HIV serostatus influenced HbA1c. The results of our study support incorporating HbA1c into routine clinical blood work in PLWH.

中文翻译：

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HIV 血清状态对 HbA1c 有什么影响？使用连续血糖监测进行前瞻性分析


目的 据报道，2 型糖尿病 (T2D) 在艾滋病毒感染者 (PLWH) 中更为常见。临床指南建议对 PLWH 进行糖尿病筛查，但由于研究报告 PLWH 的 HbA1c 错误地偏低，因此没有一致的方法。这些研究是在艾滋病毒时代早期进行的，当时参与者正在服用目前很少使用的较旧的抗逆转录病毒治疗制剂。我们的目的是调查 HIV 血清状态是否影响 HbA1c。研究设计和方法 我们对 PLWH 以及年龄和性别匹配的 HIV 阴性参与者进行了一项前瞻性队列研究，这些参与者是从英国布莱顿的诊所特意招募的。每位参与者佩戴 Dexcom G6 连续血糖监测仪 (CGM) 长达 10 天，在口服葡萄糖耐量试验期间测量了葡萄糖，并测量了果糖胺和配对的 HbA1c。我们进行回归分析来评估 HIV 对 HbA1c 的影响，并使用单独的 CGM 葡萄糖、静脉葡萄糖和果糖胺模型。此外，我们还纳入了之前探索 HbA1c 差异的研究中使用的预测变量。结果 我们招募了 60 名 PLWH（90% 男性，50% 患有 T2D，平均年龄 ± SD 年龄 57 ± 10.7 岁，100% 病毒载量检测不到）和 48 名未感染 HIV 的人（92% 男性，30% 患有 T2D，平均年龄 57.7 ± 8.9 岁）年）。我们发现回归模型中 HIV 血清状态对 HbA1c 没有显着影响。结论 我们对血糖进行了全面评估，以评估 HIV 血清状态是否影响 HbA1c。我们没有发现任何强有力的证据表明 HIV 血清状态影响 HbA1c。我们的研究结果支持将 HbA1c 纳入 PLWH 的常规临床血液检查中。