BACKGROUND AND OBJECTIVE: To assess the presence of insulin resistance in human immunodeficiency virus (HIV)-infected patients receiving long-term antiretroviral therapy. PATIENTS AND METHOD: Cross-sectional study in consecutive HIV-infected patients treated with regimens containing efavirenz, lopinavir/ritonavir or atazanavir. Insulin resistance was assessed by HOMA (Homeostasis Model Assessment). RESULTS: We analyzed 47 patients, 18 on treatment with efavirenz, 17 with lopinavir/ritonavir and 12 with atazanavir. Patients treated with lopinavir/ritonavir had higher insulinemia than those treated with efavirenz (p = 0.007) or atazanavir (p = 0.020). The HOMA index was also higher in subjects treated with lopinavir/ritonavir than in those receiving efavirenz (p = 0.07) or atazanavir (p = 0.028). Insulin resistance was found in 5 (10.6%) patients, 4 among those receiving lopinavir/ritonavir, one among those treated with efavirenz and none among subjects receiving atazanavir (p = 0.065). In the logistic regression analysis, the antiretroviral regimen was associated with risk of insulin resistance. CONCLUSIONS: A substantial number of patients on antiretroviral therapy may have insulin resistance according to the HOMA index. Alterations of the hydrocarbonated metabolism appear to be more likely to occur in patients receiving regimens with lopinavir/ritonavir.
BACKGROUND AND OBJECTIVE: To assess the presence of insulin resistance in human immunodeficiency virus (HIV)-infectedpatients receiving long-term antiretroviral therapy. PATIENTS AND METHOD: Cross-sectional study in consecutive HIV-infectedpatients treated with regimens containing efavirenz, lopinavir/ritonavir or atazanavir. Insulin resistance was assessed by HOMA (Homeostasis Model Assessment). RESULTS: We analyzed 47 patients, 18 on treatment with efavirenz, 17 with lopinavir/ritonavir and 12 with atazanavir. Patients treated with lopinavir/ritonavir had higher insulinemia than those treated with efavirenz (p = 0.007) or atazanavir (p = 0.020). The HOMA index was also higher in subjects treated with lopinavir/ritonavir than in those receiving efavirenz (p = 0.07) or atazanavir (p = 0.028). Insulin resistance was found in 5 (10.6%) patients, 4 among those receiving lopinavir/ritonavir, one among those treated with efavirenz and none among subjects receiving atazanavir (p = 0.065). In the logistic regression analysis, the antiretroviral regimen was associated with risk of insulin resistance. CONCLUSIONS: A substantial number of patients on antiretroviral therapy may have insulin resistance according to the HOMA index. Alterations of the hydrocarbonated metabolism appear to be more likely to occur in patients receiving regimens with lopinavir/ritonavir.
Authors: Mitchell E Geffner; Kunjal Patel; Denise L Jacobson; Julia Wu; Tracie L Miller; Rohan Hazra; Mariana Gerschenson; Tanvi Sharma; Margarita Silio; Jennifer Jao; Jody K Takemoto; Russell B Van Dyke; Linda A DiMeglio Journal: AIDS Date: 2018-03-13 Impact factor: 4.177
Authors: Sudeep P Pushpakom; Claire Taylor; Ruwanthi Kolamunnage-Dona; Catherine Spowart; Jiten Vora; Marta García-Fiñana; Graham J Kemp; John Whitehead; Thomas Jaki; Saye Khoo; Paula Williamson; Munir Pirmohamed Journal: BMJ Open Date: 2015-10-15 Impact factor: 2.692