%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Paengsai, N.
%A Jourdain, Gonzague
%A Salvadori, N.
%A Tantraworasin, A.
%A Mary, J. Y.
%A Cressey, T. R.
%A Chaiwarith, R.
%A Bowonwatanuwong, C.
%A Bhakeecheep, S.
%A Kosachunhanun, N.
%T Recommended first-line antiretroviral therapy regimens and risk of diabetes mellitus in HIV-infected adults in resource-limited settings
%D 2019
%L fdi:010077877
%G ENG
%J Open Forum Infectious Diseases
%@ 2328-8957
%K antiretroviral treatment regimen ; diabetes mellitus ; efavirenz ; HIV ; ritonavir-boosted lopinavir
%K THAILANDE
%M ISI:000510164000003
%N 10
%P ofz298 [7]
%R 10.1093/ofid/ofz298
%U https://www.documentation.ird.fr/hor/fdi:010077877
%> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers20-02/010077877.pdf
%V 6
%W Horizon (IRD)
%X 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 >= 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.
%$ 052 ; 050