Protease Inhibitor Use, Age and Increased Weight Associated with Diabetes in the Women's Interagency HIV Study (WIHS)

By Brian Boyle, MD

Protease inhibitor (PI) use has previously been associated with the development of diabetes mellitus. In a study published in the Journal of Acquired Immune Deficiency Syndromes, participants in the Women's Interagency HIV Study (WIHS) - a prospective, multicenter, cohort study in 6 inner-city clinics in the United States - were evaluated in order to determine the association of PI use and other patient characteristics with the development of diabetes mellitus (DM).

The study involved 1785 no pregnant women who had no history of prior DM and included women on a PI, on nucleoside analogues (NAs) only, on no antiretroviral (ARV) therapy and who are HIV-negative. Among these patients, 69 developed diabetes mellitus. The incidence of DM among the patients was 2.8, 1.2, 1.2 and 1.4 cases per 100 patient-years in patients on a PI, NAs only, no ARVs, and HIV-negative respectively (P = 0.01 and 0.06 for comparison of the PI group with the RTI and HIV-negative groups, respectively). Significant, independent risk factors for DM using the multivariate models included PI use (hazard ratio [HR] = 2.90, P = 0.002), age (HR = 1.75 per 10 years; P = 0.0002) and increased body mass index.

The authors conclude, "PI use was associated with a threefold increase in the risk of reporting incident DM. Routine screening for diabetes, particularly among older and heavier patients using PI therapy, is advisable."

03/14/03

Reference
J Justman and others. Protease Inhibitor Use and the Incidence of Diabetes Mellitus in a Large Cohort of HIV-Infected Women Journal of Acquired Immune Deficiency Syndromes 2003;32:298-302.

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