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High Risk of Renal Complications After Type 2 Diabetes Mellitus Diagnosis in People with HIV Compared with People Without HIV: Findings From the Cohort Study on Morbidity and HIV in Sweden (COSMOHS)
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EACS 2025 Oct 15-18 Paris
I. Killander Möller1,2
ABSTRACT
Purpose: We aimed to assess whether, among individuals with type 2 diabetes mellitus (T2DM), people with HIV (PWH) face a higher risk of adverse outcomes compared with those without HIV (PWoH), using data from the Cohort Study on Morbidity and HIV in Sweden (COSMOHS).
Method: Nationwide study including all Swedish residents born between 1930 and 2006, diagnosed with T2DM between 2010 and 2019 (n=312,018) by linking 10 nationwide registers. Inclusion was time of T2DM-diagnosis, at which HIV-diagnosis was assessed. Adverse outcomes were assessed after T2DM diagnosis until end of study (2024-12-31): acute kidney injury (AKI), ≥40% decline of estimated glomerular filtration rate (eGFR), major adverse kidney event (MAKE), coronary heart disease, stroke, major adverse cardiovascular event (MACE), and all-cause mortality. Cox proportional hazard models estimated adjusted hazard ratios (adjHR) by HIV-status, adjusting for propensity score quintiles based on age, sex, migrant status, co-morbidities, education, and income.
Results: There were 350 PWH and 311,668 PWoH diagnosed with T2DM. At time of T2DM-diagnosis, PWH were younger (54y vs 63y), had a lower BMI (28 vs 31kg/m2), and higher median HbA1c (52 vs 50mmol/mol) compared to PWoH. Median time of follow-up was 7.8y (IQR 6.0-10.3) in PWH and 8.8y (IQR 6.4-11.7) in PWoH. All-cause mortality was lower in PWH (11%) vs. PWoH (20%), although, after adjustment no significant difference were seen. PWH had higher risk of AKI (adjHR 1.85. 95% CI 1.26-2.72), 40% decline of eGFR (adjHR 1.49. 95% CI 1.03-2.14), and MAKE (adjHR 1.76 95% CI 1.34-2.31). No difference in risk of coronary heart disease, stroke, MACE, by HIV-status was identified.
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