Journal Article

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

Adankie, Birhanemeskel T., Amogne, Wondwossen, Shibeshi, Workineh, Aklillu, Eleni, Tadesse, Wondmagegn Tamiru, Engidawork, Ephrem

2022

Overview

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). 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. 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. 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.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Acquired immune deficiency syndrome / Adult / AIDS / Alkynes - therapeutic use / Anti-HIV Agents - therapeutic use / Antiretroviral agents / Antiretroviral drugs / Antiretroviral therapy / Antiretroviral Therapy, Highly Active - methods / Atazanavir / Atazanavir Sulfate - therapeutic use / Benzoxazines - therapeutic use / Biology and Life Sciences / Blood glucose / Blood Glucose - analysis / Carts / Complications and side effects / Cross-Sectional Studies / Cyclopropanes - therapeutic use / Diabetes / Diabetes mellitus / Disorders / Dosage and administration / Drug Combinations / Drug therapy / Drug therapy, Combination / Drug Therapy, Combination - adverse effects / Drug Therapy, Combination - methods / Efavirenz / Ethiopia - epidemiology / Fasting / Female / Glucose / Glucose - metabolism / Glucose Metabolism Disorders - epidemiology / Glucose Metabolism Disorders - virology / Health aspects / Health sciences / HIV / HIV - pathogenicity / HIV infection / HIV Infections - metabolism / Homeostasis / Hospitals / Human immunodeficiency virus / Humans / Insulin / Insulin - metabolism / Insulin resistance / Laboratories / Male / Medicine / Medicine and Health Sciences / Metabolic diseases / Metabolic disorders / Metabolism / Mortality / Patients / Pharmacology / Pharmacy / Physical Sciences / Prevalence / Regression models / Research and Analysis Methods / Risk factors / Ritonavir / Ritonavir - therapeutic use / Sample size / Sociodemographics / Triglycerides / Type 2 diabetes / Variables / Zidovudine