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Long-term exposure to protease inhibitors may increase diabetes risk in HIV
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In patients with HIV infection, the use of protease inhibitor regimens for an extended period may increase the risk for diabetes, according to recent findings.
However, HIV infection itself does not appear to have an independent correlation with increased diabetes risk.
In the retrospective, observational study, researchers collected data on 6,816 patients with HIV infection aged at least 18 years (median age, 39 years; 57% male) whose records were accessible through the South Carolina Medicaid system and the HIV/AIDS Reporting System Database between 1994 and 2011. The patients were matched in a 1:1 ratio with non–HIV-infected patients of similar age, race/ethnicity, gender and length and year of enrollment. The researchers recorded the usage of different types of antiretroviral medications during the study by year and tracked the incidence rate of diabetes per 1,000 person-years of follow-up in both groups.
The incidence rate of diabetes was higher in the non–HIV-infected group than in the HIV-infected group (13.6 vs. 11.35 per 1,000 person-years), and there was a significantly lower risk for incident diabetes among HIV-infected participants treated with combination antiretroviral therapy (adjusted HR=0.55; 95% CI, 0.46-0.65).
However, in the HIV-infected group, there was a significantly higher risk for diabetes associated with long-term exposure to protease inhibitors during the study (adjusted RR=1.35; 95% CI, 1.03-1.78). This correlation was not significant for exposure to non-nucleoside reverse transcriptase inhibitors, the researchers said. In the overall study population, there was a correlation between increased diabetes risk and female gender, older age, non-white race, and pre-existing conditions such as hypertension, dyslipidemia, obesity and hepatitis C virus infection.
“This investigation has suggested that HIV infection may not be independently associated with an increased risk of diabetes,” the researchers wrote. “However, pre-existing comorbid conditions such as hypertension, obesity and dyslipidemia remain the strongest predictors of diabetes. Among combination antiretroviral therapy medications, exposure to protease inhibitors may significantly increase the risk of developing diabetes.”
Disclosure: The researchers report no relevant financial disclosures.
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