IDWeek 2019 — Highest risk of diabetes in protease and integrase inhibitor antiretroviral therapy


  • Devona Williams, Pharm.D.
  • Conference Reports
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Takeaway

  • Antiretroviral therapy (ART) with integrase inhibitors and protease inhibitors compared with non-nucleoside reverse transcriptase inhibitors increases the risk of diabetes in people living with HIV (PLWH).

Why this matters

  • Choice of ART for PLWH can affect secondary health outcomes such as diabetes and is an important factor to consider at therapy initiation.

Study design

  • Adults initiating ART in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) from 2007 to 2016.
  • Primary outcome to measure the incidence of diabetes defined by HbA1c or diabetes-related medications.

Key results

  • Patients on protease inhibitors had a higher risk of incident diabetes also (HR=1.25; CI 1.05-1.49).
  • Raltegravir was associated with the highest incident risk of diabetes (HR=1.5; CI 1.11-2.03).
  • There was no statistically significant increase in risk for incident diabetes in patients taking integrase inhibitors and non-nucleoside transcriptase inhibitors (HR=1.22; CI 0.95-1.57).

Limitations

  • Drug exposure was not randomized.
  • Shorter follow-up for integrase inhibitors compared with other drug classes.