• Lijun Xu, Mengsha Chen, Chunhui Yan, Xiaofeng Li, Xiaoli Ni, Minghang Zhou, Weiwei Xu, Junfang Xu, and Shigui Yang.
• National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
• Ann. Med. 2025 Dec 1; 57 (1): 24279102427910.

BackgroundUpdate, the link between HIV infection and abnormal glucose metabolism (AGM) is still unclear. This study aims to investigate the impact of HIV infection on AGM, including insulin resistance (IR), impaired fasting glucose (IFG), and diabetes mellitus (DM).MethodsA multicenter case-control study was conducted in Zhejiang province, China. After matching, the study included 1030 people living with HIV (PLWH) and 1030 people living without HIV (PLWTH). The age-specific incidence of AGM was compared between the two groups. Poisson regression models were used to calculate the relative risk (RR) and its 95% confidence interval (CI) to assess the associations.ResultsCompared to PLWTH, PLWH had a higher rate of IR, IFG and DM, and a higher risk of developing IR (RR: 1.83; 95% CI: 1.60-2.10), IFG (RR: 3.87; 95% CI: 2.55-6.07), and DM (RR: 1.52; 95% CI: 1.09-2.12). In the 30-44 age group, the risk of IR, IFG, and DM was the highest, with RRs of 2.04 (95%CI: 1.69-2.48), 7.46 (95%CI: 2.91-25.27), and 1.88 (95%CI: 0.90-4.10). HIV acquisition and cART usage >5 years were associated with increased risks of DM.ConclusionHIV infection is associated with early onset and high prevalence of IR and IFG. Longer duration of HIV infection and cART usage increased the occurrence of DM. These findings contribute to a better understanding of age-specific AGM and the modified glucose monitor strategies in PLWH.

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