The prevalence of diabetes mellitus and pancreatitis complications in HIV infected individuals in Nyeri District
Njagi, Samuel Maina
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Advanced HIV infection causes acquired immunodefiency syndrome (AIDS) a condition in human in which the immune system is unable to fight off other diseases and other opportunistic infections. Upon entry, HIV infects vital cells in the human immune system such as helper T cells, also called CD4 cells, macrophages and dendritic cells leading to lower levels of these cells in the body. The virus lives and multiplies primarily in the white blood cells, the immune cells that normally protect one from diseases. The hallmark of HIV infection is the progressive loss of a specific type of immune cells called CD4 cells weakening the immune system and leaving the individual vulnerable to various opportunistic infections (OIs) and other illnesses, ranging from pneumonia to cancer. Complications such as hyperglycemia/diabetes and pancreatitis have lately been associated with the onset of HIV infection and although documentation and studies on this relationship are not many, a few studies have indicated that 11 in every 100 HIV -positive individuals are diabetic and over 17% of HIV -positive have pancreatitis. The objective of this study was therefore to determine the prevalence of diabetes and pancreatitis by considering some diabetes risk factors, which included glucose metabolism and pancreas state in HIV infected individuals. Assessment of the state of glucose metabolism in the body was evaluated using the concentrations of blood glucose while pancreatitis was evaluated using the rate of amylase enzyme activity (amylase levels). The HIV infection was based on CD4 count and viral load. The study involved 193 participants who were grouped into two groups of 97 subjects of HIV negative individuals (also referred to as study control group) and 96 participants who were HIV-positive. In the study 13.54% of HIV infected individuals were hyperglycemic compared to 6.18% in HIV negative population with a mean blood glucose of 7.6±5.l and 4.4±1.1 respectively, while the mean amylase level was 110.0±28-1 in HIV -positive individuals compared to 82.8±24.2 in the HIV negative group, the CD4 mean was 888.8±244.1 and 308.8±249.8 in the HIV negative group and in the HIV infected individuals respectively. The study showed significant negative correlation between amylase levels and CD4 count (P<0.05) (r= -0.451) and also a significant positive correlation between amylase levels and viral load (P<0.05) (r=0.697); this confirmed that elevated amylase level which is suggestive of pancreatitis results from advancement in HIV infection, a probable cause of abnormality in glucose metabolism in HIV positive individual. Although hyperglycemic was notable in HIV positive, there was no correlation between amylase levels and glucose levels (P>0.05) (r=0.311), there was also no correlation between blood sugar levels and CD4 counts (P>0.05) (r=- 0.023) and between blood sugar and viral loads (P>0.05) (r=0.035). This may suggest that abnormality in glucose metabolism in HIV infected individuals is as a result of a complex interaction of many diabetes mellitus risk factors.