Association of hyperglycemia with Tenofovir+Lamivudine+Dolutegravir (TLD) or Tenofovir+Lamivudine+Efavirenz (TLE) antiretroviral regimens in patients living with HIV: a retrospective cohort study.
DOI:
https://doi.org/10.71637/tnhj.v25i2.949Keywords:
Anti-retroviral drugs, Human immunodeficiency virus, Dolutegravir, hyperglycemia, retrospective cohortAbstract
Background: Dolutegravir (DTG) is recommended as first-line treatment for HIV infected adults, pregnant women and children older than 12 years. However, emerging evidence suggests an association between dolutegravir and hyperglycemia. Hence, we evaluated the association of hyperglycemia in adult patients living with HIV receiving either Tenofovir+Lamivudine+Dolutegravir (TLD) or Tenofovir+Lamivudine+Efavirenz (TLE) regimens.
Methods: A retrospective cohort study was conducted wherein medical records of 250 HIV infected adults, registered at the ART Centre of a tertiary care public hospital and receiving either TLD or TLE regimens for at least 6 months were reviewed following ethical approval. Demographic details, ART drug regimen details, HbA1c values, fasting blood glucose levels, antidiabetic drug details and adverse drug reactions were captured and association between ART medications and hyperglycemia was analysed.
Results: Women were the predominant population in both cohorts with mean body weight being significantly higher in the TLD cohort (62.29 vs.58.74 kg) [p=0.02]. Significantly larger number of patients receiving TLD regimen (30.4%) were predisposed to hyperglycemic events (14.4%) [p=0.002]. Significantly higher HbA1c values and mean fasting glucose levels was observed in the TLD cohort with 13.6% patients initiated on antidiabetic treatment [p=0.02].
Conclusion: TLD regimen was found to be associated with a significant increase in hyperglycemic events and dysregulation of glucose metabolism. Thus, patients on TLD regimen should have frequent glucose monitoring and management with antidiabetic therapy, if required, so long as the benefits of these drugs in delaying HIV disease progression outweigh the risks involved.
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