广西医学

目的分析接受抗逆转录病毒治疗（ART）的HIV感染者/AIDS患者（HIV/AIDS者）中低病毒血症（LLV）与糖尿病的关系。方法采用回顾性队列研究的方法，选取广西2004—2023年接受ART的HIV/AIDS者作为研究对象。收集患者的人口学特征与临床特征，统计治疗期间糖尿病的发生情况，并根据是否发生LLV将HIV/AIDS者分为非LLV 组和LLV组。通过倾向性评分匹配来平衡非LLV组和LLV组的基线资料。在倾向性评分匹配前后，采用Kaplan⁃Meier法绘制LLV组与非LLV组发生糖尿病的风险曲线，并使用COX回归模型进行单因素和多因素分析。结果纳入11 570例接受ART的HIV/AIDS者，其中LLV组1 002例、非LLV组10 568例，共有1 819例HIV/AIDS者（15.7%）发生糖尿病。倾向性评分匹配前后，风险曲线均提示LLV组的糖尿病发生风险高于非LLV组（P<0.05）。倾向性评分匹配前后，多因素COX回归分析结果均提示LLV是接受ART的HIV/AIDS者发生糖尿病的危险因素（P<0.05），其中LLV的HIV/AIDS者发生糖尿病的风险分别是非LLV的HIV/AIDS者的1.369、1.309倍。结论在接受ART的HIV/AIDS者中，LLV的HIV/AIDS者比非LLV的HIV/AIDS者更容易发生糖尿病。建议关注HIV/AIDS者的ART管理，加强LLV人群的血糖监测，及时对血糖异常者进行干预，从而减少该人群糖尿病的发生。

Objective To analyze the relation of low level viraemia (LLV) with diabetes mellitus in HIV infected individuals/AIDS patients (HIV/AIDS patients) receiving antiretroviral therapy (ART). Methods HIV/AIDS patients receiving ART in Guangxi from 2004 to 2023 were selected as the research subjects by employing the method of retrospective cohort study. The demographic characteristics and clinical characteristics of patients were collected. The occurrence states of diabetes mellitus during treatment were statistically analyzed, and HIV/AIDS patients were assigned to non⁃LLV group or LLV group according to the presence of LLV. The baseline data from the non⁃LLV and LLV groups were balanced by the propensity score matching. After the pre⁃ and post⁃propensity score matching, the Kaplan⁃Meier method was employed to draw risk curve of the occurrence of diabetes mellitus in the LLV and non⁃LLV groups, and univariate and multivariate analyses were performed by using the COX regression model. Results A total of 11 570 HIV/AIDS patients receiving ART were enrolled, therein there were 1002 cases in the LLV group, and 10 568 cases in the non⁃LLV group. A total of 1819 (15.7%) HIV/AIDS patients suffered from diabetes mellitus. After the propensity score matching, the risk curve revealed that the occurrence risk of diabetes mellitus in the LLV group was higher than that in the non⁃LLV group (P<0.05). Before and after the propensity score matching, the results of multivariate COX regression analysis indicated that LLV was the risk factor for the occurrence of diabetes mellitus in HIV/AIDS patients receiving ART (P<0.05), therein the risk of HIV/AIDS patients with LLV suffering from diabetes mellitus was 1.369 and 1.309 times higher than that of HIV/AIDS patients without LLV, respectively. Conclusion Among HIV/AIDS patients receiving ART, HIV/AIDS patients with LLV are more likely to suffer from diabetes mellitus compared with HIV/AIDS patients without LLV. It is suggested to pay attention to ART management of HIV/AIDS patients, strengthen blood glucose monitoring of LLV population, and timely intervene in patients with abnormal blood glucose, so as to reduce the occurrence of diabetes mellitus.