TY - JOUR
T1 - Homeostatic model assessment for insulin resistance index trajectories in HIV-infected patients treated with different first-line antiretroviral regimens
AU - Gianotti, Nicola
AU - Muccini, Camilla
AU - Galli, Laura
AU - Poli, Andrea
AU - Spagnuolo, Vincenzo
AU - Andolina, Andrea
AU - Galizzi, Nadia
AU - Ripa, Marco
AU - Messina, Emanuela
AU - Piatti, Pier Marco
AU - Lazzarin, Adriano
AU - Castagna, Antonella
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Objective: To describe the trajectories of the homeostatic model assessment for insulin resistance (HOMA-IR) index in a cohort of HIV-1 infected patients during their first-line antiretroviral (ART) regimen. Methods: Retrospective analysis of naïve patients who started ART from 2007 at the Infectious Diseases Unit of the San Raffaele Hospital, Milan. We included patients treated with two nucleoside reverse transcriptase inhibitors (NRTIs, tenofovir, abacavir, lamivudine or emtricitabine), and one anchor drug (ritonavir-boosted protease inhibitor [PI/r], non-NRTI [NNRTI], or integrase strand transfer inhibitor [InSTI]), and with HOMA-IR assessed both before and after the start of ART. Univariate and multivariate mixed linear models estimated HOMA-IR changes during ART. Results: Among 618 patients included in the study, 218 received InSTI-, 210 PI/r-, and 190 NNRTI-based regimens. Median follow-up was 27.4 (16.3-41.2) months. Adjusted mean change in HOMA-IR index was significantly higher (P =.041) in patients treated with InSTI-based regimens [0.160 (95% CI: 0.003-0.321) units per year] compared with NNRTI-based regimens [−0.005 (95% CI: −0.184-0.074) units per year]; no difference was observed between patients treated with NNRTI- and PI/r-based regimens or between INSTI-based and PI/r-based regimens. Conclusion: InSTI-based first-line ARTs were independently associated with greater increases in HOMA-IR index.
AB - Objective: To describe the trajectories of the homeostatic model assessment for insulin resistance (HOMA-IR) index in a cohort of HIV-1 infected patients during their first-line antiretroviral (ART) regimen. Methods: Retrospective analysis of naïve patients who started ART from 2007 at the Infectious Diseases Unit of the San Raffaele Hospital, Milan. We included patients treated with two nucleoside reverse transcriptase inhibitors (NRTIs, tenofovir, abacavir, lamivudine or emtricitabine), and one anchor drug (ritonavir-boosted protease inhibitor [PI/r], non-NRTI [NNRTI], or integrase strand transfer inhibitor [InSTI]), and with HOMA-IR assessed both before and after the start of ART. Univariate and multivariate mixed linear models estimated HOMA-IR changes during ART. Results: Among 618 patients included in the study, 218 received InSTI-, 210 PI/r-, and 190 NNRTI-based regimens. Median follow-up was 27.4 (16.3-41.2) months. Adjusted mean change in HOMA-IR index was significantly higher (P =.041) in patients treated with InSTI-based regimens [0.160 (95% CI: 0.003-0.321) units per year] compared with NNRTI-based regimens [−0.005 (95% CI: −0.184-0.074) units per year]; no difference was observed between patients treated with NNRTI- and PI/r-based regimens or between INSTI-based and PI/r-based regimens. Conclusion: InSTI-based first-line ARTs were independently associated with greater increases in HOMA-IR index.
KW - HOMA-IR index
KW - insulin resistance
KW - integrase strand transfer inhibitors
KW - non-nucleoside reverse transcriptase inhibitors
KW - protease inhibitors
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U2 - 10.1002/jmv.25541
DO - 10.1002/jmv.25541
M3 - Article
C2 - 31286527
AN - SCOPUS:85072056410
VL - 91
SP - 1937
EP - 1943
JO - Journal of Medical Virology
JF - Journal of Medical Virology
SN - 0146-6615
IS - 11
ER -