<?xml version="1.0"?>
<oai_dc:dc xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
  <dc:title>Recommended first-line antiretroviral therapy regimens and risk of diabetes mellitus in HIV-infected adults in resource-limited settings</dc:title>
  <dc:creator>Paengsai, N.</dc:creator>
  <dc:creator>/Jourdain, Gonzague</dc:creator>
  <dc:creator>Salvadori, N.</dc:creator>
  <dc:creator>Tantraworasin, A.</dc:creator>
  <dc:creator>Mary, J. Y.</dc:creator>
  <dc:creator>Cressey, T. R.</dc:creator>
  <dc:creator>Chaiwarith, R.</dc:creator>
  <dc:creator>Bowonwatanuwong, C.</dc:creator>
  <dc:creator>Bhakeecheep, S.</dc:creator>
  <dc:creator>Kosachunhanun, N.</dc:creator>
  <dc:subject>antiretroviral treatment regimen</dc:subject>
  <dc:subject>diabetes mellitus</dc:subject>
  <dc:subject>efavirenz</dc:subject>
  <dc:subject>HIV</dc:subject>
  <dc:subject>ritonavir-boosted lopinavir</dc:subject>
  <dc:description>Objective. The use of some antiretroviral drugs has been associated with a higher risk of diabetes mellitus (DM) in HIV-infected patients, but the risk associated with antiretroviral drug combinations remains unclear. We investigated the association between first-line antiretroviral therapy (ART) regimens, recommended by the World Health Organization (WHO) in 2016, and the risk of DM in adults. Method. We selected all HIV-infected adults within the Thai National AIDS Program who started a first-line ART regimen consisting the following between October 2006 and September 2013: zidovudine+lamivudine+nevirapine; tenofovir disoproxil fumarate (TDF)+lamivudine+nevirapine; zidovudine+lamivudine+efavirenz; TDF+lamivudine/emtricitabine+efavirenz; zidovudine+lamivudine+ritonavir-boosted lopinavir (LPV/r); or TDF+lamivudine+LPV/r. Diagnosis of DM was defined as having at least 2 of the following characteristics: fasting plasma glucose &gt;= 126 mg/dl, 2010 WHO ICD-10 codes E11-E14, or prescription of antidiabetic drugs. To identify ART regimens associated with DM, we used competing risks regression models that considered mortality without DM as a competing event and adjusted for sex, age, pancreas disease, and stratified by groups defined by a score summarizing the propensity to receive a specific first-line ART regimen. Results. Data from 35 710 adults (49.1% male; median age, 35.0 years; median follow-up, 2.0 years) were included. In the multivariable analysis with zidovudine+lamivudine+nevirapine as the reference group, a higher risk of DM was observed with TDF+lamivudine/emtricitabine+efavirenz (adjusted sub-distribution hazard ratio [aSHR], 1.6; 95% confidence interval [CI], 1.3-1.9), zidovudine+lamivudine+efavirenz (aSHR, 2.0; 95% CI, 1.7-2.3), and TDF+lamivudine+LPV/r (aSHR, 2.7; 95% CI, 1.9-3.9). Conclusions. Several of the WHO recommended ART regimens, particularly tenofovir + lamivudine +LPV/r and regimens containing efavirenz, may be associated with an increased risk of DM.</dc:description>
  <dc:date>2019</dc:date>
  <dc:type>text</dc:type>
  <dc:identifier>https://www.documentation.ird.fr/hor/fdi:010077877</dc:identifier>
  <dc:identifier>fdi:010077877</dc:identifier>
  <dc:identifier>Paengsai N., Jourdain Gonzague, Salvadori N., Tantraworasin A., Mary J. Y., Cressey T. R., Chaiwarith R., Bowonwatanuwong C., Bhakeecheep S., Kosachunhanun N.. Recommended first-line antiretroviral therapy regimens and risk of diabetes mellitus in HIV-infected adults in resource-limited settings. 2019, 6 (10),  ofz298 [7p.]</dc:identifier>
  <dc:language>EN</dc:language>
  <dc:coverage>THAILANDE</dc:coverage>
</oai_dc:dc>
