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Association between switching to integrase strand transfer inhibitors and incident diabetes in people with HIV.
Hwang, Y Joseph; Lesko, Catherine R; Brown, Todd T; Alexander, G Caleb; Zalla, Lauren C; Keruly, Jeanne C; Snow, LaQuita N; Pytell, Jarratt D; Falade-Nwulia, Oluwaseun; Jones, Joyce L; Moore, Richard D; Fojo, Anthony T.
Afiliación
  • Hwang YJ; Department of Medicine, Johns Hopkins University School of Medicine.
  • Lesko CR; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
  • Brown TT; Department of Medicine, Johns Hopkins University School of Medicine.
  • Alexander GC; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
  • Zalla LC; Department of Medicine, Johns Hopkins University School of Medicine.
  • Keruly JC; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
  • Snow LN; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
  • Pytell JD; Department of Medicine, Johns Hopkins University School of Medicine.
  • Falade-Nwulia O; Department of Medicine, Johns Hopkins University School of Medicine.
  • Jones JL; Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
  • Moore RD; Department of Medicine, Johns Hopkins University School of Medicine.
  • Fojo AT; Department of Medicine, Johns Hopkins University School of Medicine.
AIDS ; 38(11): 1696-1702, 2024 Sep 01.
Article en En | MEDLINE | ID: mdl-38864578
ABSTRACT

OBJECTIVE:

Integrase strand transfer inhibitors (INSTI) are associated with weight gain in people with HIV (PWH), but their impact on diabetes is unclear. We evaluated the association between switching from nonnucleoside reverse-transcriptase inhibitors (NNRTI) or protease inhibitors (PI) to INSTI and incident diabetes.

DESIGN:

Longitudinal cohort study.

METHODS:

We included PWH aged ≥18 years from the Johns Hopkins HIV Clinical Cohort (2007-2023) without history of diabetes who had used NNRTI or PI for ≥180 days. We followed participants up to 10 years from HIV primary care visits where they switched to INSTI or continued NNRTI or PI. We estimated the hazard of incident diabetes associated with switching to INSTI using weighted Cox regression with robust variance estimator.

RESULTS:

We included 2075 PWH who attended 22 116 visits where they continued NNRTI or PI and 631 visits where they switched to INSTI. Switching to INSTI was associated with a weighted hazard ratio (wHR) of 1.11 [95% confidence interval (CI), 0.77-1.59] for incident diabetes. The association if no weight gain occurred during the first two years was not qualitatively different (wHR 1.22; 95% CI, 0.82-1.80). In a posthoc analysis, switching to INSTI conferred a significant wHR of 1.79 (95% CI, 1.13-2.84) for diabetes within the first two years but not after.

CONCLUSIONS:

Switching from NNRTI or PI to INSTI did not significantly increase overall diabetes incidence in PWH, although there may be elevated risk in the first two years. These findings can inform considerations when switching to INSTI-based regimens.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Inhibidores de Integrasa VIH / Diabetes Mellitus Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: AIDS Asunto de la revista: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Inhibidores de Integrasa VIH / Diabetes Mellitus Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: AIDS Asunto de la revista: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido