New research suggests that patients with HIV using protease inhibitor regimens long term may have a higher risk of diabetes. The study, published in Diabetic Medicine, found that the HIV infection by itself does not seem to increase the risk of diabetes, however.
To conduct the study, researchers collected data on 6,816 patients infected with HIV at least 18 years old; the median age of the patients was 39 years and 57 percent of the population was male. These patients’ medical records were accessible through the South Carolina Medicaid system and the HIV/AIDS Reporting System Database between 1994 and 2011. For a comparison group, these patients were matched in a 1:1 ratio with non-HIV infected patients who were of similar age, race/ethnicity, gender and length and year of enrollment. The researchers tracked the incidence rate of diabetes in both groups and also recorded the different types of antiretroviral medications used.
The researchers found that in the non-HIV infected group, the incidence rate of diabetes was higher. Additionally, the HIV-infected participants treated with combination antiretroviral therapy had a lower risk of incident diabetes. However, the risk of diabetes was significantly higher in the HIV-infected group associated with long-term exposure to protease inhibitors. In the overall study population, an increased risk of diabetes was linked to female gender, older age, non-white race and pre-existing conditions such as high blood pressure, dyslipidemia, obesity and hepatitis C.
The authors of the study concluded “HIV infection may not be independently associated with increased risk of diabetes. Among HIV-infected persons, exposure to protease inhibitor-based regimens may increase the risk of diabetes. Healthcare providers should make every effort to use combination antiretroviral therapy regimens with a better cardiometabolic profile.”
Protease inhibitors are a type of antiviral drug used to treat HIV/AIDs and hepatitis C. Some examples of protease inhibitors include Fortovase (saquinavir), Norvir (ritonavir), Viracept (nelfinavir) and Agenerase (amprenavir).