Long-Term Exposure to Protease Inhibitors May Increase Diabetes Risk in HIV

This article was reported by Healio.

Healio reported on a study of the effect of long-term exposure to antiretrovirals (ARVs) and increased diabetes risk in HIV-positive individuals. Researchers conducted a retrospective observational study using 1994-2011 data from the South Carolina Medicaid system and the HIV/AIDS reporting system databases.

Researchers compared data on 6,816 HIV-positive individuals ages 18 and older with data on HIV-negative individuals matched for age, race/ethnicity, gender, and length and year of enrollment. Researchers also tracked the types of ARVs the HIV-positive patients used during the study and incidence rate of diabetes per 1,000 person-years of follow-up for HIV-positive and HIV-negative individuals.

Results show that diabetes incidence was higher in the HIV-negative individuals than in the HIV-positive individuals and there was a much lower risk of diabetes among HIV-positive individuals treated with combination ARVs. HIV-positive individuals with long-term exposure to protease inhibitors had a higher diabetes risk, but HIV-positive individuals treated with non-nucleoside reverse transcriptase inhibitors did not share this higher risk.

The researchers found a correlation between diabetes risk and female gender, older age, non-white race, and preexisting conditions such as obesity, dyslipidemia, hypertension, and hepatitis C virus infection. The researchers suggest that preexisting conditions are the strongest diabetes predictors, but exposure to protease inhibitors may increase the risk significantly.

The full report, "Incidence of Diabetes Mellitus in a Population-Based Cohort of HIV-Infected and Non-HIV-Infected Persons: The Impact of Clinical and Therapeutic Factors Over Time," was published online in the journal Diabetic Medicine (2014; doi: 10.1111/dme.12455).