Prevalence and predictors of glucose metabolism disorders among People Living with HIV on combination antiretroviral therapy.

Autor: Tadesse WT; Department of Pharmacology and Clinical Pharmacology, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia., Adankie BT; Department of Medical Microbiology, School of Medicine, St. Paul Specialized Hospital Millennium Medical College, Addis Ababa, Ethiopia., Shibeshi W; Department of Pharmacology and Clinical Pharmacology, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia., Amogne W; Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia., Aklillu E; Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institute, Stockholm, Sweden., Engidawork E; Department of Pharmacology and Clinical Pharmacology, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2022 Jan 19; Vol. 17 (1), pp. e0262604. Date of Electronic Publication: 2022 Jan 19 (Print Publication: 2022).
DOI: 10.1371/journal.pone.0262604
Abstrakt: Objective: We investigated prevalence and predictors of glucose metabolism disorders (GMDs) among People Living with HIV (PLWH) on efavirenz- and atazanavir/ritonavir-based combination antiretroviral therapy (cART).
Methods: This cross-sectional study involved adult PLWH on efavirenz- (n = 240) and atazanavir/ritonavir-based (n = 111) cART. The prevalence of GMDs was determined by fasting serum glucose, insulin, and homeostasis model assessment. A logistic regression model was used to determine predictors.
Results: The overall prevalence of GMDs for all regimens was 27.6% (97/351) [95% CI 23.0-32.6%] s, with 31.1% (75/240) [95% CI 25.4-37.5%] for efavirenz-based and 19.8% (22/111) [95% CI 12.9-28.5%)] for atazanavir/ritonavir-based cART group. The prevalence of impaired fasting glycemia was significantly higher (p = 0.026) in the efavirenz- [(15.4%) (37/240); 95%CI (11.1-20.6%)] than atazanavir/ritonavir-based [(7.2%) (8/111), (95%CI (3.2-13.7%)] cART. However, no significant difference was observed in the prevalence of diabetes mellitus and insulin resistance between the two regimens. Age ≥46 years old and specific type of ARV contained in cART, such as TDF, were independent predictors of GMD in both groups. Whereas the male gender and BMI category were predictors of GMDs among EFV-based cART group, AZT- and ABC- containing regimens and triglyceride levels were predictors in the ATV/r-based group.
Conclusions: GMDs were highly prevalent among adults on EFV- than ATV/r-based cARTs. Age ≥46 years and TDF-containing cARTs are common predictors in both regimens. Close monitoring for impaired fasting glucose during long-term EFV-based cART is recommended for early diagnosis of type-2 diabetes and management.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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