HIV感染者合并糖尿病的风险与管理

Risk and Clinical Management of HIV-Infected Patients with Diabetes Mellitus

ART延长了HIV感染者的生命。但HIV感染者生存期的延长也引发了非艾滋病定义相关疾病(如代谢综合征、心脑血管疾病等)防治的重视。糖尿病已成为HIV感染者常见的并发症,但我国尚缺乏HIV感染合并糖尿病的风险数据,也缺少相关并发症、预后及治疗干预等循证医学证据,故HIV感染合并糖尿病患者的风险与临床管理需要进一步的规范。随着新一代ART药物在我国的广泛应用,HIV感染合并糖尿病患者的特殊治疗策略尤其是药物之间的相互作用需要进一步的探讨。本文概述了国内外HIV感染合并糖尿病的流行病学、风险因素、新一代ART对糖代谢的影响以及HIV感染合并糖尿病患者的筛查和治疗最新进展,并提出了未来可能的研究方向和趋势。

ART has prolonged the life of patient with HIV(PWH),which also attracted attention to the prevention and treatment of non-AIDS-defined diseases,such as metabolic syndrome,cardio-cerebrovascular diseases,etc.Diabetes has become a common complication of PWH.However,in China,there is a shortage of data on the risk of PWH with diabetes,as well as evidence-based medical documentation such as related chronic complications,prognosis and treatment interventions.Therefore,the risk and clinical management of PWH with diabetes needs to be further standardized.As the new generation of ART drugs are widely used in China,the peculiar treatment algorithm for PWH with diabetes,especially the interaction between various drugs,should be extensively investigated.This article outlines the epidemiology,risk factors,impact of new generation ART on glucose metabolism,as well as the latest progress on screening and treatment for PWH with diabetes at home and abroad.Specifically,this article proposes the research direction for PWH with diabetes.