Predictors of glucose metabolism and blood pressure among Ethiopian individuals with HIV/AIDS after one‐year of antiretroviral therapy

Abstract

Objective Better understanding of glucose metabolism in patients with HIV after initiating antiretroviral therapy (ART) is important to target treatment and follow‐up for diabetes risk and other non‐communicable diseases in resource‐limited settings. The aim of this study was to assess the changes and predictors of glucose metabolism and blood pressure among patients with HIV on ART for 12 months. Methods One‐year follow‐up of Ethiopian patients with HIV after initiation of ART was done. Outcomes were changes in fasting plasma glucose (FPG), and 30‐minute (30mPG) and 2‐hour plasma glucose (2hPG) after oral glucose tolerance test, glycated haemoglobin (HbA1c), fasting plasma insulin (p‐insulin), homeostatic model assessment index for insulin resistance (HOMA‐IR) and blood pressure. Results The mean age was 33 years, and the majority were women. During the first 12 months, levels of all plasma glucose parameters decreased, while p‐insulin (10B 3.1; 95% CI2.4, 4.0), HOMA‐IR (10B 3.1; 95% CI2.3, 4.0) and systolic blood pressure (B 4.0; 95% CI2.5, 5.5) increased. Fat‐free mass at baseline predicted higher increments in p‐insulin, HOMA‐IR and blood pressure; whereas, fat mass predicted higher increment in HbA1c. Conclusions Among Ethiopian patients with HIV, blood pressure and insulin increased, and all glucose parameters declined during 12‐month of ART. Only longer‐term follow‐up will tell us whether insulin increase is due to insulin resistance or from recovering β‐cells.

Distinct patterns of fasting plasma glucose and lipid profile levels over time in adults tested positive for HIV on HAART in Shanghai, China, revealed using growth mixture models

“…Few of the patients observed a strong non-linear increase in FPG, with a rising growth rate in the last few years of follow-up after a slight decrease in the first year. A recent study also showed that FPG declined and insulin increased during 12 months of ART, indicating that there might be an improvement in insulin secretion and health ( 30 ). In addition, some studies have shown that the longer the duration of HAART, the higher the risk of diabetes ( 31 , 32 ), reflecting the possible cumulative effects of HIV infection or ART on diabetes.…”

Characterizing blood pressure trajectories in people living with HIV following antiretroviral therapy: A systematic review

“…For these studies, follow-up time ranged from 1 month to 1 year. The majority of the articles reported an increase in systolic BP (4.0-7.0 mmHg) [21,23,24] and half of them found an increase in diastolic BP (2.3-6.6 mmHg) [23,24] in the year following ART initiation. Two studies measure at 6-month follow-up and report inconsistent results [22,23].…”

“…Sample size and demographic characteristics were heterogenous across short follow-up studies. Three studies had predominantly male cohorts [22][23][24], while one had a predominantly female cohort [21]. Race and ethnicity were also heterogeneous among those cohorts.…”

“…Participants in these studies were also on different combinations of ART regimens. Two studies have cohorts on nonnucleoside reverse transcriptase inhibitor (NNRTI)-based ART regimens [21,23] and the remaining two studies have subjects on both NNRTI-and protease inhibitor (PI)-based ART regimens [22,24] (Table 2). For these studies, follow-up time ranged from 1 month to 1 year.…”

Alterações metabólicas em pessoas que vivem com HIV: estudo de coorte retrospectivo

“…Outros estudos corroboram com o aumento da PA ao longo do tratamento. Uma pesquisa realizada Etiópia com 318 PVHIV, foi evidenciado que desde os 12 meses após o início da TARV, há elevação da PA (AMARE et al, 2021). Resultado preocupante, considerando a associação de maiores níveis pressóricos ao aumento do risco de mortalidade em PVHIV, sobretudo os que já iniciam o tratamento com histórico de HA (BATAVIA et al, 2018).…”