Cargando…

The risk of hyperglycemia associated with use of dolutegravir among adults living with HIV in Kampala, Uganda: A case-control study

Emerging evidence suggests a possible association between hyperglycemia and dolutegravir (DTG), a preferred first-line antiretroviral agent in sub-Saharan Africa (SSA). There is need for rigorous studies to validate this association in the face of increasing DTG use and burden of non-communicable di...

Descripción completa

Detalles Bibliográficos
Autores principales: Namara, Daphine, Schwartz, Jeremy I, Tusubira, Andrew K, McFarland, Willi, Birungi, Caroline, Semitala, Fred C, Muddu, Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9691558/
https://www.ncbi.nlm.nih.gov/pubmed/36222490
http://dx.doi.org/10.1177/09564624221129410
_version_ 1784837064041168896
author Namara, Daphine
Schwartz, Jeremy I
Tusubira, Andrew K
McFarland, Willi
Birungi, Caroline
Semitala, Fred C
Muddu, Martin
author_facet Namara, Daphine
Schwartz, Jeremy I
Tusubira, Andrew K
McFarland, Willi
Birungi, Caroline
Semitala, Fred C
Muddu, Martin
author_sort Namara, Daphine
collection PubMed
description Emerging evidence suggests a possible association between hyperglycemia and dolutegravir (DTG), a preferred first-line antiretroviral agent in sub-Saharan Africa (SSA). There is need for rigorous studies to validate this association in the face of increasing DTG use and burden of non-communicable diseases among people living with HIV (PLHIV). We conducted a case–control study to assess the risk of hyperglycemia associated with use of DTG among PLHIV attending Mulago ISS Clinic in Kampala. Cases had hyperglycemia while controls had no hyperglycemia as confirmed by fasting plasma glucose and oral glucose tolerance tests. Demographic, laboratory, and clinical data were collected using interviewer-administered questionnaires and medical record abstraction. Analysis compared cases and controls on DTG use prior to diagnosis of hyperglycemia while controlling for potential confounders using multivariable logistic regression. We included 204 cases and 231 controls. In multivariable analysis, patients with prior DTG use had seven times greater odds of subsequent diagnosis of hyperglycemia compared to those who had non-DTG-based regimens (adjusted odds ratio [aOR] 7.01, 95% CI 1.96–25.09). The odds of hyperglycemia also increased with age (56 years and above vs. 18–35, aOR 12.38, 95% CI 3.79–40.50) and hypertension (aOR 5.78, 95% CI 2.53–13.21). Our study demonstrates a strong association between prior DTG exposure and subsequent diagnosis of hyperglycemia. Given the benefits of DTG, wide-scale use, and the growing burden of diabetes mellitus (DM) in SSA, there is need for systematic screening for hyperglycemia and consideration of alternate regimens for those at risk for DM.
format Online
Article
Text
id pubmed-9691558
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-96915582022-11-29 The risk of hyperglycemia associated with use of dolutegravir among adults living with HIV in Kampala, Uganda: A case-control study Namara, Daphine Schwartz, Jeremy I Tusubira, Andrew K McFarland, Willi Birungi, Caroline Semitala, Fred C Muddu, Martin Int J STD AIDS Original Research Articles Emerging evidence suggests a possible association between hyperglycemia and dolutegravir (DTG), a preferred first-line antiretroviral agent in sub-Saharan Africa (SSA). There is need for rigorous studies to validate this association in the face of increasing DTG use and burden of non-communicable diseases among people living with HIV (PLHIV). We conducted a case–control study to assess the risk of hyperglycemia associated with use of DTG among PLHIV attending Mulago ISS Clinic in Kampala. Cases had hyperglycemia while controls had no hyperglycemia as confirmed by fasting plasma glucose and oral glucose tolerance tests. Demographic, laboratory, and clinical data were collected using interviewer-administered questionnaires and medical record abstraction. Analysis compared cases and controls on DTG use prior to diagnosis of hyperglycemia while controlling for potential confounders using multivariable logistic regression. We included 204 cases and 231 controls. In multivariable analysis, patients with prior DTG use had seven times greater odds of subsequent diagnosis of hyperglycemia compared to those who had non-DTG-based regimens (adjusted odds ratio [aOR] 7.01, 95% CI 1.96–25.09). The odds of hyperglycemia also increased with age (56 years and above vs. 18–35, aOR 12.38, 95% CI 3.79–40.50) and hypertension (aOR 5.78, 95% CI 2.53–13.21). Our study demonstrates a strong association between prior DTG exposure and subsequent diagnosis of hyperglycemia. Given the benefits of DTG, wide-scale use, and the growing burden of diabetes mellitus (DM) in SSA, there is need for systematic screening for hyperglycemia and consideration of alternate regimens for those at risk for DM. SAGE Publications 2022-10-12 2022-12 /pmc/articles/PMC9691558/ /pubmed/36222490 http://dx.doi.org/10.1177/09564624221129410 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research Articles
Namara, Daphine
Schwartz, Jeremy I
Tusubira, Andrew K
McFarland, Willi
Birungi, Caroline
Semitala, Fred C
Muddu, Martin
The risk of hyperglycemia associated with use of dolutegravir among adults living with HIV in Kampala, Uganda: A case-control study
title The risk of hyperglycemia associated with use of dolutegravir among adults living with HIV in Kampala, Uganda: A case-control study
title_full The risk of hyperglycemia associated with use of dolutegravir among adults living with HIV in Kampala, Uganda: A case-control study
title_fullStr The risk of hyperglycemia associated with use of dolutegravir among adults living with HIV in Kampala, Uganda: A case-control study
title_full_unstemmed The risk of hyperglycemia associated with use of dolutegravir among adults living with HIV in Kampala, Uganda: A case-control study
title_short The risk of hyperglycemia associated with use of dolutegravir among adults living with HIV in Kampala, Uganda: A case-control study
title_sort risk of hyperglycemia associated with use of dolutegravir among adults living with hiv in kampala, uganda: a case-control study
topic Original Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9691558/
https://www.ncbi.nlm.nih.gov/pubmed/36222490
http://dx.doi.org/10.1177/09564624221129410
work_keys_str_mv AT namaradaphine theriskofhyperglycemiaassociatedwithuseofdolutegraviramongadultslivingwithhivinkampalaugandaacasecontrolstudy
AT schwartzjeremyi theriskofhyperglycemiaassociatedwithuseofdolutegraviramongadultslivingwithhivinkampalaugandaacasecontrolstudy
AT tusubiraandrewk theriskofhyperglycemiaassociatedwithuseofdolutegraviramongadultslivingwithhivinkampalaugandaacasecontrolstudy
AT mcfarlandwilli theriskofhyperglycemiaassociatedwithuseofdolutegraviramongadultslivingwithhivinkampalaugandaacasecontrolstudy
AT birungicaroline theriskofhyperglycemiaassociatedwithuseofdolutegraviramongadultslivingwithhivinkampalaugandaacasecontrolstudy
AT semitalafredc theriskofhyperglycemiaassociatedwithuseofdolutegraviramongadultslivingwithhivinkampalaugandaacasecontrolstudy
AT muddumartin theriskofhyperglycemiaassociatedwithuseofdolutegraviramongadultslivingwithhivinkampalaugandaacasecontrolstudy
AT namaradaphine riskofhyperglycemiaassociatedwithuseofdolutegraviramongadultslivingwithhivinkampalaugandaacasecontrolstudy
AT schwartzjeremyi riskofhyperglycemiaassociatedwithuseofdolutegraviramongadultslivingwithhivinkampalaugandaacasecontrolstudy
AT tusubiraandrewk riskofhyperglycemiaassociatedwithuseofdolutegraviramongadultslivingwithhivinkampalaugandaacasecontrolstudy
AT mcfarlandwilli riskofhyperglycemiaassociatedwithuseofdolutegraviramongadultslivingwithhivinkampalaugandaacasecontrolstudy
AT birungicaroline riskofhyperglycemiaassociatedwithuseofdolutegraviramongadultslivingwithhivinkampalaugandaacasecontrolstudy
AT semitalafredc riskofhyperglycemiaassociatedwithuseofdolutegraviramongadultslivingwithhivinkampalaugandaacasecontrolstudy
AT muddumartin riskofhyperglycemiaassociatedwithuseofdolutegraviramongadultslivingwithhivinkampalaugandaacasecontrolstudy