• 1.

    Guariguata L, Linnenkamp U, Beagley J, Whiting DR, Cho NH , 2014. Global estimates of the prevalence of hyperglycaemia in pregnancy. Diabetes Res Clin Pract 103: 176185.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Vounzoulaki E, Khunti K, Abner SC, Tan BK, Davies MJ, Gillies CL , 2020. Progression to type 2 diabetes in women with a known history of gestational diabetes: systematic review and meta-analysis. BMJ 369: m1361.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Kalra S, Kalra B, Agrawal N, Unnikrishnan A , 2011. Understanding diabetes in patients with HIV/AIDS. Diabetol Metab Syndr 3: 2.

  • 4.

    Brown TT, Cole SR, Li X, Kingsley LA, Palella FJ, Riddler SA, Visscher BR, Margolick JB, Dobs AS , 2005. Antiretroviral therapy and the prevalence and incidence of diabetes mellitus in the multicenter AIDS cohort study. Arch Intern Med 165: 11791184.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Jeon CY, Murray MB , 2008. Diabetes mellitus increases the risk of active tuberculosis: a systematic review of 13 observational studies. PLoS Med 5: e152.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Soepnel LM, Norris SA, Schrier VJMM, Browne JL, Rijken MJ, Gray G, Klipstein-Grobusch K , 2017. The association between HIV, antiretroviral therapy, and gestational diabetes mellitus. AIDS 31: 113125.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Biadgo B, Ambachew S, Abebe M, Melku M , 2019. Gestational diabetes mellitus in HIV-infected pregnant women: a systematic review and meta-analysis. Diabetes Res Clin Pract 155: 107800.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Alexander M, Gupta A, Mathad JS, 2019. Is there a connection between gestational diabetes mellitus, human immunodeficiency virus infection, and tuberculosis? Int J Tuberc Lung Dis 23: 1925.

    • Search Google Scholar
    • Export Citation
  • 9.

    Ramesh B, Alexander M, Deshpande P, Kulkarni V, Gupte N, Gupta A, Mathad J , 2021. Stages of pregnancy and HIV affect diagnosis of tuberculosis infection and Mycobacterium tuberculosis (MTB)-induced immune response: findings from PRACHITi, a cohort study in Pune, India. Int J Infect Dis 112: 205211.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    QuantiFERON-TB Gold Plus (QFT-Plus) Package Insert , 2019. Instruction manual in the Quantiferon test kit. Germantown, MD: Qiagen.

  • 11.

    Library WRH , 2020. WHO Recommendation on the Diagnosis of Gestational Diabetes in Pregnancy. Geneva, Switzerland: World Health Organization.

    • Search Google Scholar
    • Export Citation
  • 12.

    Misra A , 2015. Ethnic-specific criteria for classification of body mass index: a perspective for Asian Indians and American diabetes association position statement. Diabetes Technol Ther 17: 667671.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Murata H, Hruz PW, Mueckler M , 2000. The mechanism of insulin resistance caused by HIV protease inhibitor therapy. J Biol Chem 275: 2025120254.

  • 14.

    Mynarcik DC, McNurlan MA, Steigbigel RT, Fuhrer J, Gelato MC , 2000. Association of severe insulin resistance with both loss of limb fat and elevated serum tumor necrosis factor receptor levels in HIV lipodystrophy. J Acquir Immune Defic Syndr 25: 312321.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Mathad JS et al.2016. Sex-related differences in inflammatory and immune activation markers before and after combined antiretroviral therapy initiation. J Acquir Immune Defic Syndr 73: 123129.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Mmasa KN et al., 2021. Gestational diabetes in women living with HIV in Botswana: lower rates with dolutegravir- than with efavirenz-based antiretroviral therapy. HIV Med 22: 715722.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Haeri S, Shauer M, Dale M, Leslie J, Baker AM, Saddlemire S, Boggess K , 2009. Obstetric and newborn infant outcomes in human immunodeficiency virus-infected women who receive highly active antiretroviral therapy. Am J Obstet Gynecol 201: 315.e1315.e5.

    • Search Google Scholar
    • Export Citation
  • 18.

    Staimez LR, Deepa M, Ali MK, Mohan V, Hanson RL, Narayan KMV , 2019. Tale of two Indians: heterogeneity in type 2 diabetes pathophysiology. Diabetes Metab Res Rev 35: e3192.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Inaishi J, Saisho Y , 2017. Ethnic similarities and differences in the relationship between beta cell mass and diabetes. J Clin Med 6: 113.

    • Search Google Scholar
    • Export Citation
  • 20.

    Faurholt-Jepsen D et al.2014. Diabetes is associated with lower tuberculosis antigen-specific interferon gamma release in Tanzanian tuberculosis patients and non-tuberculosis controls. Scand J Infect Dis 46: 384391.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Vallerskog T, Martens GW, Kornfeld H , 2010. Diabetic mice display a delayed adaptive immune response to Mycobacterium tuberculosis. J Immunol 184: 62756282.

    • PubMed
    • Search Google Scholar
    • Export Citation
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The Association of Gestational Diabetes with HIV Infection and Tuberculosis in Indian Women

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  • 1 Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York;
  • | 2 Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Trial Unit, Pune, Maharashtra, India;
  • | 3 Department of OB-GYN, Byramjee Jeejeebhoy Government Medical College, Pune, Maharashtra, India;
  • | 4 Division of Infectious Diseases, Departments of Medicine and International Health, Johns Hopkins School of Medicine, Baltimore, Maryland;
  • | 5 Department of Biostatistics, Center for Global Health, Weill Cornell Medicine, New York, New York;
  • | 6 National Institute for Research in Tuberculosis, Chennai, India;
  • | 7 National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland;
  • | 8 Department of OB-GYN, Weill Cornell Medicine, New York, New York
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ABSTRACT.

Infection of HIV is associated with an increased diabetes risk, which also increases tuberculosis risk. It is unknown if similar associations exist with gestational diabetes (GDM). We screened pregnant women living with and without HIV for GDM using oral glucose tolerance testing. In a subgroup of women with latent tuberculosis (positive interferon-gamma [IFN-γ] release assay), we used supernatants from tuberculosis antigen tubes to compare cytokine levels from women with and without GDM, matched by age and HIV status. Of 234 women, 21 (9%) had GDM, 13.9% living with HIV, and 6.5% without HIV (P = 0.06). Compared with women without GDM, women with GDM had lower median IFN-γ (19.1 versus 141.9 pg/mL, P = 0.03) and interleukin-2 (18.7 versus 249 pg/mL, P < 0.01). Our study suggests that HIV infection is associated with an increased risk of GDM, which is associated with decreased Mycobacterium tuberculosis immune responses. Gestational diabetes screening should be prioritized in tuberculosis-endemic countries, especially in women living with HIV.

Author Notes

Address correspondence to Puja Chebrolu, Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York City, NY 10065-6304. E-mail: puc9005@med.cornell.edu

Financial support: Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health under award number R01HD081929 (A. G., J. S. M., M. A., N. G., and R. B.), by NIAID (National Institute of Allergy and Infectious Diseases) of the National Institutes of Health under award number UM1AI069465 (A. G. and N. G.) and K23AI129854 (J. S. M.), by the Fogarty International Center of the National Institutes of Health under award number D43TW009574 (S. N.) and D43TW009337 (P. C.), by the Weill Cornell Department of Medicine, Ujala Foundation, Kellen Foundation, Willowcroft Foundation, and Wyncote Foundation. We also acknowledge the support of Persistent in development of electronic data capture system. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or of the named company or Foundations.

Authors’ addresses: Puja Chebrolu and Daniel Fitzgerald, Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, NY, E-mails: puc9005@med.cornell.edu and dwf2001@med.cornell.edu. Mallika Alexander, Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Trial Unit, Pune, Maharashtra, India, E-mail: mallika.alexander@yahoo.com. Ramesh Bhosale, Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Trial Unit, Pune, Maharashtra, India, and Department of OB-GYN, Byramjee Jeejeebhoy Government Medical College, Pune, Maharashtra, India, E-mail: drrameshbhosale@gmail.com. Shilpa Naik, Department of OB-GYN, Byramjee Jeejeebhoy Government Medical College, Pune, Maharashtra, India, E-mail: shilunnaik@yahoo.co.in. Nikhil Gupte and Amita Gupta, Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Trial Unit, Pune, Maharashtra, India, and Division of Infectious Diseases, Departments of Medicine and International Health, Johns Hopkins School of Medicine, Baltimore, MD, E-mails: nikhil_jhumit@yahoo.com and agupta25@jhmi.edu. Myung Hee Lee, Department of Biostatistics, Center for Global Health, Weill Cornell Medicine, New York, NY, E-mail: myl2003@med.cornell.edu. Pavan Kumar, National Institute for Research in Tuberculosis, Chennai, India, E-mail: pavankumarn@nirt.res.in. Subash Babu, National Institute for Research in Tuberculosis, Chennai, India, and National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, E-mail: sbabu@mail.nih.gov. Jyoti Mathad, Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, NY, and Department of OB-GYN, Weill Cornell Medicine, New York, NY, E-mail: jsm9009@med.cornell.edu.

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