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Long-term Protease Inhibitor Use May Increase Diabetes Risk in People with HIV

Apr 23, 2014

Recent study findings show that patients with HIV infections who use a protease inhibitor regimen for an extended period to treat HIV may increase their risk for diabetes.

The study, to appear in the journal Diabetic Medicine, examines data on 6,816 patients with HIV infection at least 18 years old (median age, 39 years; 57% male) whose records were accessible through the South Carolina Medicaid system and the HIV/AIDS Reporting System Database between 1994 and 2011, according to

The patients with HIV were matched in a 1:1 ratio with non–HIV-infected patients of similar age, race/ethnicity, gender, and length and year of enrollment, reports. The researchers recorded their use of antiretroviral medications during the study by year and tracked the incidence rate of diabetes per 1,000 person-years of follow-up in both groups. The incidence rate of diabetes was higher in the non–HIV-infected group than in the HIV-infected group (13.6 vs. 11.35 per 1,000 person-years), and there was a significantly lower diabetes risk among HIV-infected participants treated with combination antiretroviral therapy (adjusted HR = 0.55; 95% CI, 0.46-0.65).

The HIV-infected group, however, showed a significantly higher risk for diabetes associated with long-term exposure to protease inhibitors during the study period (adjusted RR = 1.35; 95% CI, 1.03-1.78). In the overall study population, there was a correlation between increased diabetes risk and female gender, older age, non-white race, and pre-existing conditions such as hypertension, dyslipidemia, obesity, and hepatitis C infection, Healio reports.

“HIV infection may not be independently associated with an increased risk of diabetes,” the researchers wrote, but “exposure to protease inhibitors may significantly increase the risk of developing diabetes,” according to

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