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Incidence of diabetes in HIV-infected patients treated with first-line integrase strand transfer inhibitors: a French multicentre retrospective study
- Source :
- Journal of Antimicrobial Chemotherapy, Journal of Antimicrobial Chemotherapy, Oxford University Press (OUP), 2020, 75 (11), pp.3344-3348. ⟨10.1093/jac/dkaa330⟩
- Publication Year :
- 2020
- Publisher :
- HAL CCSD, 2020.
-
Abstract
- BackgroundIntegrase strand transfer inhibitors (INSTIs) are increasingly used in patients living with HIV due to their safety, effectiveness and high genetic barrier. However, an association with weight gain has recently been suggested and several cases of diabetes mellitus have been reported with raltegravir and dolutegravir. The long-time metabolic impact of these recent molecules remains unclear.ObjectivesTo assess if an INSTI as a third agent is statistically associated with new-onset diabetes mellitus compared with an NNRTI or a PI.Patients and methodsPatients undergoing first-line combined ART (cART) without diabetes at baseline were retrospectively included from the Dat’AIDS French cohort study (ClinicalTrials.gov NCT02898987). Incident diabetes mellitus was defined as a notification of new diabetes in the medical history, a glycated haemoglobin (HbA1c) level superior to 7.5% or the start of a diabetes therapy following the initiation of ART.ResultsFrom 2009 to 2017, 19 462 patients were included, among which 265 cases of diabetes mellitus occurred. Multivariate and survival analyses did not highlight an increase in new-onset diabetes in patients undergoing cART with an INSTI as a third agent compared with an NNRTI or a PI. BMI >30 kg/m2, age >37 years old (in survival analysis), black race or Hispanic ethnicity, arterial hypertension and AIDS were associated with a higher proportion of incident diabetes.ConclusionsINSTIs were not statistically associated with new-onset diabetes. However, clinicians should remain aware of this possible metabolic comorbidity, particularly in patients with a high BMI and older patients.
- Subjects :
- 0301 basic medicine
Microbiology (medical)
Adult
medicine.medical_specialty
[SDV]Life Sciences [q-bio]
Integrase inhibitor
HIV Infections
HIV Integrase
Diabetes Therapy
Cohort Studies
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases
Internal medicine
Diabetes mellitus
medicine
Diabetes Mellitus
Humans
Pharmacology (medical)
030212 general & internal medicine
HIV Integrase Inhibitors
ComputingMilieux_MISCELLANEOUS
Retrospective Studies
Pharmacology
Integrases
business.industry
Incidence
Retrospective cohort study
Raltegravir
medicine.disease
Comorbidity
3. Good health
030104 developmental biology
Infectious Diseases
chemistry
Dolutegravir
business
medicine.drug
Cohort study
Subjects
Details
- Language :
- English
- ISSN :
- 03057453 and 14602091
- Database :
- OpenAIRE
- Journal :
- Journal of Antimicrobial Chemotherapy, Journal of Antimicrobial Chemotherapy, Oxford University Press (OUP), 2020, 75 (11), pp.3344-3348. ⟨10.1093/jac/dkaa330⟩
- Accession number :
- edsair.doi.dedup.....3fe743becfec80f10d678efe4f49200e