Disglicemia e sua associação com fatores sociodemográficos, clínicos e comportamentais em pessoas vivendo com HIV : estudo de coorte

Abstract

HIV is among the most severe diseases affecting the immune system. While the introduction of antiretroviral therapy has substantially reduced morbidity and mortality rates, the use of these medications may lead to various adverse effects, including dysglycemia and insulin resistance, ultimately resulting in Diabetes Mellitus. Such effects can exert a significant social, clinical, and economic impact. Objective: To examine the occurrence of dysglycemia and its correlation with sociodemographic, clinical, and behavioral factors in people living with HIV (PLHIV) over a 60-month period of antiretroviral therapy (ART) usage. Method: This study employs a cohort design and involves the examination of medical records from individuals living with HIV who are receiving care at a specialized service in Maceió. We included records of patients who initiated antiretroviral therapy between January 1, 2014, and March 30, 2015. The follow-up period spanned 60 months. Data from 123 medical records were collected using a semi-structured instrument. Dysglycemia was the primary outcome variable under investigation. Results: Dysglycemia was found in 19.5% (n=24) of the medical records following antiretroviral usage. Significant alterations in glucose levels were noted at 24 months (p=0.008), 48 months (p=0.006), and 60 months (p=0.011) post-therapy initiation. A notable increase in dysglycemia incidence was observed when comparing pre- and post-60- month treatment periods (p=0.013). Additionally, an association was identified between dysglycemia and Caucasian ethnicity (OR: 2.5; CI: 1.3-4.7, p=0.003). Conclusion: Significant glucose level alterations were observed among individuals living with HIV over a 60-month period, alongside factors potentially contributing to these changes. Hence, there is a pressing need for the development of targeted strategies aimed at promoting, preventing, and managing these risk factors. Moreover, fostering lifestyle modifications is deemed essential.