HIV and diabetes in Africa

Abstract

Over 22.9 million people in sub-Saharan Africa are infected with HIV representing nearly 70% of the world’s total population of people living with HIV and AIDS (PLWHA).1 Substantial funding from governments and non-government groups has led to a dramatic scale-up in provision of highly active antiretroviral treatment (HAART) across the continent in the last decade. There are now over 5 million Africans on HAART. This is a remarkable feat given the challenges of providing HIV care in resource-limited settings. Indeed HAART has significantly altered the natural history of this life-threatening condition. However as children and adults are living longer on HAART there is increasing concern about rising incidence of insulin resistance glucose intolerance type 2 diabetes and dyslipidaemia among PLWHA. This review describes how HIV infection and exposure to antiretroviral therapy can affect glycaemic control and onset of diabetic complications. We also review diabetes among HIV-infected children and diabetes management in patients on HAART with particular focus on which anti-diabetic drugs are safe and effective.