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Antiretroviral Therapy and the Prevalence and Incidence of Diabetes—Reply

Antiretroviral Therapy and the Prevalence and Incidence of Diabetes—Reply In reply Mikhail and Cope comment on our recent article, “Antiretroviral Therapy and the Prevalence and Incidence of Diabetes Mellitus in the Multicenter AIDS Cohort Study,”1 in which we conclude that the incidence of diabetes mellitus in men with human immunodeficiency virus (HIV) infection undergoing highly active antiretroviral therapy (HAART) was 4 times greater than that found in HIV-seronegative men. First, Mikhail and Cope state that we did not mention that our results cannot be extrapolated to women or nonwhite racial groups. Our results may or may not generalize to women and nonwhite racial groups as stated in the second paragraph of the “Comment” section. Indeed, the rate ratio of diabetes mellitus owing to HIV and HAART will generalize to these other groups if sex and race do not modify the relation between HIV and HAART and diabetes mellitus, assuming there is no measurement error. Second, Mikhail and Cope correctly point out that we did not account for family history in the analysis presented in our article. Family history data were available from April 2000 onward in our cohort, a year after the baseline visit for our analysis. Adjusting for family history of diabetes when possible in the incidence analysis alters the summary rate ratio for HIV-infected men receiving HAART compared with men without HIV from 4.1 (95% confidence interval, 1.85-9.16) to 3.9 (95% confidence interval, 1.75-8.72), a 5% change. Therefore, accounting for measured family history does not affect the interpretation of our findings. Third, Mikhail and Cope state that we did not mention the limitation that we defined diabetes mellitus based on a single fasting glucose measurement, but this is the first limitation addressed in the last paragraph of the “Comment” section. Finally, Mikhail and Cope astutely observe that the references were not published in the correct sequence; the ARCHIVES is publishing a correction in this issue for the misnumbered reference section. Correspondence: Dr Brown, The Johns Hopkins University School of Medicine, 1830 E Monument St, No. 333, Baltimore, MD 21287 (tbrown27@jhmi.edu). References 1. Brown TTCole SRLi X et al. Antiretroviral therapy and the prevalence and incidence of diabetes mellitus in the Multicenter AIDS Cohort Study. Arch Intern Med 2005;1651179- 1184PubMedGoogle ScholarCrossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Antiretroviral Therapy and the Prevalence and Incidence of Diabetes—Reply

Antiretroviral Therapy and the Prevalence and Incidence of Diabetes—Reply

Abstract

In reply Mikhail and Cope comment on our recent article, “Antiretroviral Therapy and the Prevalence and Incidence of Diabetes Mellitus in the Multicenter AIDS Cohort Study,”1 in which we conclude that the incidence of diabetes mellitus in men with human immunodeficiency virus (HIV) infection undergoing highly active antiretroviral therapy (HAART) was 4 times greater than that found in HIV-seronegative men. First, Mikhail and Cope state that we did not mention that our results...
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Publisher
American Medical Association
Copyright
Copyright © 2005 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.165.21.2537-a
Publisher site
See Article on Publisher Site

Abstract

In reply Mikhail and Cope comment on our recent article, “Antiretroviral Therapy and the Prevalence and Incidence of Diabetes Mellitus in the Multicenter AIDS Cohort Study,”1 in which we conclude that the incidence of diabetes mellitus in men with human immunodeficiency virus (HIV) infection undergoing highly active antiretroviral therapy (HAART) was 4 times greater than that found in HIV-seronegative men. First, Mikhail and Cope state that we did not mention that our results cannot be extrapolated to women or nonwhite racial groups. Our results may or may not generalize to women and nonwhite racial groups as stated in the second paragraph of the “Comment” section. Indeed, the rate ratio of diabetes mellitus owing to HIV and HAART will generalize to these other groups if sex and race do not modify the relation between HIV and HAART and diabetes mellitus, assuming there is no measurement error. Second, Mikhail and Cope correctly point out that we did not account for family history in the analysis presented in our article. Family history data were available from April 2000 onward in our cohort, a year after the baseline visit for our analysis. Adjusting for family history of diabetes when possible in the incidence analysis alters the summary rate ratio for HIV-infected men receiving HAART compared with men without HIV from 4.1 (95% confidence interval, 1.85-9.16) to 3.9 (95% confidence interval, 1.75-8.72), a 5% change. Therefore, accounting for measured family history does not affect the interpretation of our findings. Third, Mikhail and Cope state that we did not mention the limitation that we defined diabetes mellitus based on a single fasting glucose measurement, but this is the first limitation addressed in the last paragraph of the “Comment” section. Finally, Mikhail and Cope astutely observe that the references were not published in the correct sequence; the ARCHIVES is publishing a correction in this issue for the misnumbered reference section. Correspondence: Dr Brown, The Johns Hopkins University School of Medicine, 1830 E Monument St, No. 333, Baltimore, MD 21287 (tbrown27@jhmi.edu). References 1. Brown TTCole SRLi X et al. Antiretroviral therapy and the prevalence and incidence of diabetes mellitus in the Multicenter AIDS Cohort Study. Arch Intern Med 2005;1651179- 1184PubMedGoogle ScholarCrossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Nov 28, 2005

Keywords: diabetes mellitus,anti-retroviral agents

References