ASSOCIATIONS OF STATINS AND ANTIRETROVIRAL DRUGS WITH THE ONSET OF TYPE 2 DIABETES AMONG HIV-1-INFECTED PATIENTS

AIM
We investigated the associations of statin use and exposure to antiretroviral drugs with type 2 DM onset in a cohort of HIV-infected patients.
METHODS
This retrospective, controlled, cohort study identified HIV-1-infected patients who did not have DM and were not receiving statins at their antiretroviral treatment (ART) initiation. Follow-up was accrued from ART initiation to the earliest instance of a DM diagnosis, loss to follow-up, death, or last available visit. The incidence of DM was estimated according to statin use. The Fine-Gray competing risk model was used in the multivariate analysis to identify risk factors for developing DM.
RESULTS
The analyses evaluated 6,195 patients followed for 9.8 (IQR: 4.3–16.3) years. During 64,149 person-years of follow-up (PYFU), 235 patients developed DM (crude incidence: 3.66 [95%CI: 3.20–4.13] per 1,000 PYFU), and 917 (14%) patients used statins. After adjusting for potential confounders, statin use was associated with a non-significant increase in the risk of DM (AHR: 1.21, 95% CI: 0.71–2.07; P = 0.47). DM was more likely among patients who were ever treated with stavudine, and less likely among those ever treated using emtricitabine, tenofovir, abacavir, efavirenz, nevirapine, atazanavir or darunavir.
CONCLUSIONS
A higher risk of diabetes mellitus was not associated with statin treatment but with traditional risk factors and stavudine use while a reduced risk of DM was associated with the use of emtricitabine, tenofovir, abacavir, efavirenz, nevirapine, atazanavir or darunavir.

Vincenzo Spagnuolo
spagnuolo.vincenzo@hsr.it
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