|
|
 |
|
| Abnormality/Study
|
Incidence |
| Glucose
metabolism (HOPS)1 |
5%-17% |
| Hyperglycemia
(SALSA)2 |
15%
(Men)
6% (Women) |
| Glucose
intolerance (APROCO)3 |
16.2% |
| Glucose
metabolism4 |
23% |
| Insulin
resistance5 |
55%
(PIs)
27% (NRTIs) |
| Diabetes
mellitus2,3,6,7 |
2.4%-4.4%
|
•
Determining the prevalence and incidence of these various glucose
abnormalities is difficult since there is no clearly defined definition.
Data from several large cohorts, however, have improved our understanding
of their incidence.
• For example, in the HIV Outpatient Study, the range of impaired
glucose metabolism in study participants was 5% to 17%.1 In the self-ascertained
lipodystrophy syndrome assessment cohort, commonly referred to as
SALSA, 15% of men and 6% of women had hyperglycemia.2 The incidence
of glucose intolerance in subjects receiving PI-based HAART in the
APROCO cohort was found to be 16.2%.3
• Other studies have found the incidence of glucose metabolism
to be 23%. Insulin resistance is 55% for patients receiving PIs and
27% for patients receiving NRTIs alone.4, 5
• Finally, frank diabetes mellitus remains relatively uncommon,
with an incidence ranging from 2.4% to 4.4%.2, 3, 6, 7
References:
1. Ward DJ, Delaney KM, Moorman AC et al. Description of lipodystrophy
in the HIV Outpatient Study (HOPS). 1st International Workshop on
Adverse Drug Reactions and Lipodystrophy in HIV, San Diego, CA; June
26-29, 1999. Abstract 14.
2. Muurahainen N, Falutz J, Santos G et al. The SALSA (self-ascertained
lipodystrophy syndrome assessment) cohort: abnormalities in cases
compared to controls. 1st International Workshop on Adverse Drug Reactions
and Lipodystrophy in HIV, San Diego, CA; June 26-29, 1999. Abstract
22.
3. Aproco Study Group on Metabolic Complications. A cross-sectional
study of metabolic disorders and lipodystrophy in HIV-infected patients
treated with antiretroviral combination therapy including protease
inhibitors (PI) within a phase IV cohort study of PI: APROCO-ANRS
EP11. 1st International Workshop on Adverse Drug Reactions and Lipodystrophy
in HIV, San Diego, CA; June 26-29, 1999. Abstract 23.
4. Carr A, Samaras K, Thorisdottir A et al. Diagnosis, prediction,
and natural course of HIV-1 protease-inhibitor-associated lipodystrophy,
hyperlipidaemia, and diabetes mellitus: a cohort study. Lancet.
1999;353:2093-9.
5. Goebel FD, Walli R. ART-associated insulin resistance: frequency,
potential causes and possible therapeutic interventions. 1st International
Workshop on Adverse Drug Reactions and Lipodystrophy in HIV, San Diego,
CA; June 26 - 29, 1999. Abstract 5.
6. Duong M, Petit JM, Piroth L et al. Lipid evaluation and glucose
metabolism in HIV-infected patients before and after initiation of
protease inhibitor therapy. 39th Interscience Conference on Antimicrobial
Agents and Chemotherapy, San Francisco, CA; Sept 26 - 29, 1999. Abstract
1291.
7. Martinez E, Garcia MA, Conget I et al. Incidence, characteristics,
and prognosis of diabetes mellitus (DM) associated with protease inhibitors
(PI). 7th Conference on Retroviruses and Opportunistic Infections,
San Francisco, CA; Jan 30 - Feb 2, 2000. Abstract 16.
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