HIV Protease Inhibitors and Insulin Sensitivity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Kajogoo, Violet Dismas; Atim, Mary Gorret; Amare, Demeke; Geleta, Melka; Muchie, Yilkal; Tesfahunei, Hanna Amanuel; Olomi, Willyhelmina; Acam, Joan; Manyazewal, Tsegahun

doi:10.3389/fphar.2021.635089

Cited by 13 publications

(7 citation statements)

References 39 publications

(54 reference statements)

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“…Currently, many developments have been made in terms of managing PLWH, especially through the use of ART to suppress or reduce the viral load ( 56 ). In fact, the published literature predominately reports on recent ART combinations, especially protease inhibitors or nucleoside reverse transcriptase inhibitors, which are potentially linked with the development of non-communicable diseases, including kidney disease-associated risk factors ( 57–59 ). Notably, the sustained use of a tenofovir disoproxil fumarate-containing ART regimen has been linked with the detrimental effects of oxidative stress and inflammation, driving pathological abnormalities in renal cells ( 60 , 61 ).…”

Section: Discussionmentioning

confidence: 99%

A systematic review assessing the potential use of cystatin c as a biomarker for kidney disease in people living with HIV on antiretroviral therapy

Hanser,

Choshi,

Mokoena

et al. 2024

Front. Med.

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The introduction of antiretroviral therapy (ART) has significantly prolonged the lifespan of people living with human immunodeficiency virus (PLWH). However, the sustained use of this drug regimen has also been associated with a cluster of metabolic anomalies, including renal toxicity, which can lead to the development of kidney diseases. In this study, we reviewed studies examining kidney disease in PLWH sourced from electronic databases such as PubMed/MEDLINE, Scopus, and Google Scholar, as well as gray literature. The narrative synthesis of data from these clinical studies demonstrated that the serum levels of cystatin C remained unchanged or were not affected in PLWH on ART, while the creatinine-based glomerular filtration rate (GFR) fluctuated. In fact, some of the included studies showed that the creatinine-based GFR was increased in PLWH taking tenofovir disoproxil fumarate-containing ART, perhaps indicating that the use of both cystatin C- and creatinine-based GFRs is vital to monitor the development of kidney disease in PLWH. Clinical data summarized within this study indicate the potential detrimental effects of tenofovir-based ART regimens in causing renal tubular injury, while highlighting the possible beneficial effects of dolutegravir-based ART on improving the kidney function in PLWH. However, the summarized literature remains limited, while further clinical studies are required to provide insights into the potential use of cystatin C as a biomarker for kidney disease in PLWH.

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Section: Discussionmentioning

confidence: 99%

A systematic review assessing the potential use of cystatin c as a biomarker for kidney disease in people living with HIV on antiretroviral therapy

Hanser,

Choshi,

Mokoena

et al. 2024

Front. Med.

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“…The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. [16][17][18] We included studies that reported OBI in HIV participants in Africa. Diagnosis of OBI was laboratory-based in all studies.…”

Section: Methodsmentioning

confidence: 99%

Prevalence of occult hepatitis B among HIV-positive individuals in Africa: A systematic review and meta-analysis

2022

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The prevalence of hepatitis B virus among HIV-seropositive individuals is believed to be high, and yet the disease remains neglected in many areas of the continent. Little is known about occult hepatitis in HIV individuals. This review assessed occult hepatitis B infection and its prevalence in the different regions of the African continent. It also determines its prevalence in the HIV population which is endemic in the region. Studies were searched from the Cochrane, google scholar, PubMed/Medline, and African Journals online. Authors included cross-sectional studies, case controls, and cohorts, from 2010 to January 2021, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Participants, Interventions, Comparisons, Outcomes, and Study design frameworks to develop the search strategy. All studies had participants who were HIV-positive, covering different regions of the continent. Risk ratio was used to measure effect size, and Stata 14 software was used for analysis. Eleven studies met the eligibility criteria, with 2567 participants. Overall prevalence of occult hepatitis B was 11.2%. Regional prevalence was 26.5% for the south, 11% for the north, 9.1% for the east, and 8.5% for the western region. Approximately 10% of HIV-seropositive individuals were co-infected with occult hepatitis B virus. Regionally, the prevalence was highest in the southern region and lowest in the west. The prevalence of occult HBV infection was compared between the southern region and the other regions. It was higher in the south compared to the east (risk ratio = 0.87, 95% confidence interval (0.83–0.91)). It was also higher in the south compared to the north (risk ratio = 0.82, 95% confidence interval (0.79–0.85)), and it was also higher in the south compared to the west (risk ratio = 0.85, 95% confidence interval (0.82–0.87)). Public health measures and interventions are required to raise awareness, increase prevention, and reduce spread of the disease. More evidence-based studies need to be carried out.

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“…Undetectable HVL does not mean HIV/AIDS cure rather it escapes killing by host immunity and ART medicines through establishing dormancy in reservoirs cells and tissues like lymphoid tissues [ 12 , 13 ]. When ART is stopped, HIV reservoirs replicate and increase in number, the phenomenon called viral rebound/ recrudescence .…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have proposed a substantial proportion of post-treatment people who do not experience a rebound after stopping ARV where others maintain undetectable without ART [ 13 , 14 ]. Nonetheless, ART remains to be the cornerstone of HIV so far [ 12 – 15 ].…”

Section: Introductionmentioning

confidence: 99%

HIV viral suppression and risk of viral rebound in patients on antiretroviral therapy: a two- year retrospective cohort study in Northern Tanzania

Kahabuka,

Woldeamanuel,

Mbelele

et al. 2024

BMC Infect Dis

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Background The world is moving towards the third target of the Joint United Nations Programme on HIV/AIDS to ensure most people receiving antiretroviral therapy (ART) are virologically suppressed. Little is known about viral suppression at an undetectable level and the risk of viral rebound phenomenon in sub-Saharan Africa which covers 67% of the global HIV burden.This study aimed to investigate the proportion of viral suppression at an undetectable level and the risk of viral rebound among people living with HIV receiving ART in northern Tanzania. Methodology A hospital based-retrospective study recruited people living with HIV who were on ART for at least two years at Kibong’oto Infectious Disease Hospital and Mawenzi Regional Referral Hospital in Kilimanjaro Region, Tanzania. Participants’ two-year plasma HIV were captured at months 6, 12, and 24 of ART. Undetectable viral load was defined by plasma HIV of viral load (VL) less than 20copies/ml and viral rebound (VR) was considered to anyone having VL of more than 50 copies/ml after having history of undetectable level of the VL less than 20copies/ml. A multivariable log-binomial generalized linear model was used to determine factors for undetectable VL and viral VR. Results Among 416 PLHIV recruited, 226 (54.3%) were female. The mean (standard deviation) age was 43.7 (13.3) years. The overall proportion of undetectable VL was 68% (95% CI: 63.3–72.3) and 40.0% had viral rebound (95% CI: 34.7–45.6). Participants who had at least 3 clinic visits were 1.3 times more likely to have undetectable VL compared to those who had 1 to 2 clinic visits in a year (p = 0.029). Similarly, participants with many clinical visits ( > = 3 visits) per year were less likely to have VR compared to those with fewer visits ( = 2 visits) [adjusted relative risk (aRR) = 0.64; 95% CI: 0.44–0.93]. Conclusion Participants who had fewer clinic visits per year(ART refills) were less likely to achieve viral suppression and more likely to experience viral rebound. Enhanced health education and close follow-up of PLHIV on antiretroviral therapy are crucial to reinforce adherence and maintain an undetectable viral load.

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HIV Protease Inhibitors and Insulin Sensitivity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Cited by 13 publications

References 39 publications

A systematic review assessing the potential use of cystatin c as a biomarker for kidney disease in people living with HIV on antiretroviral therapy

A systematic review assessing the potential use of cystatin c as a biomarker for kidney disease in people living with HIV on antiretroviral therapy

Prevalence of occult hepatitis B among HIV-positive individuals in Africa: A systematic review and meta-analysis

HIV viral suppression and risk of viral rebound in patients on antiretroviral therapy: a two- year retrospective cohort study in Northern Tanzania

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