Abstract
BackgroundWith the advent of effective antiretroviral therapy, the care of patients with human immunodeficiency virus infection became more like that of other chronic diseases. Diabetes mellitus can also occur as one of the chronic illnesses affecting patients with human immunodeficiency virus infection. We report a case of newly developed diabetes mellitus in a patient with human immunodeficiency virus infection, most likely caused by the nucleoside analogue zidovudine, and its improvement after discontinuation of zidovudine.Case presentationA Chinese man in his 30s visited our outpatient clinic for routine follow-up of human immunodeficiency virus infection. Blood tests showed hyperglycemia with a glucose level of 31.8 mmol/L and hemoglobin A1c of 8.5%. He was diagnosed with diabetes mellitus and treated with oral diabetic medications. The use of zidovudine was suspected as the cause of his diabetes, and it was replaced by other antiretroviral medication. His hyperglycemia improved, and he now no longer requires diabetic medications.ConclusionsDiabetes mellitus can develop with the use of antiretroviral medications, but its occurrence associated with use of zidovudine is quite rare. Healthcare personnel should be aware of this rare, yet important, side effect.
Highlights
BackgroundWith the advent of effective antiretroviral therapy (ART; formerly known as highly active antiretroviral therapy, or HAART) in late 1990s, the prognosis of patients with human immunodeficiency virus (HIV) infection improved significantly
With the advent of effective antiretroviral therapy, the care of patients with human immunodeficiency virus infection became more like that of other chronic diseases
Diabetes mellitus can develop with the use of antiretroviral medications, but its occurrence associated with use of zidovudine is quite rare
Summary
With the advent of effective antiretroviral therapy (ART; formerly known as highly active antiretroviral therapy, or HAART) in late 1990s, the prognosis of patients with human immunodeficiency virus (HIV) infection improved significantly. Iwata and Ogawa Journal of Medical Case Reports (2017) 11:157 repeated episodes of acute pancreatitis, hypertriglyceridemia, and two episodes of amoebic liver abscess His medications included Combivir® (zidovudine and lamivudine; ViiV Healthcare, Brentford, UK), raltegravir, and fenofibrate. He was seen by a psychiatrist and had received sertraline, levomepromazine, flunitrazepam, and quazepam, but he had discontinued all medications approximately 1 month prior to the current presentation after discussion with his psychiatrist. Combivir® was switched to TRUVADA® (tenofovir disoproxil and emtricitabine; Gilead Sciences, Foster City, CA, USA) 4 months after the detection of diabetes mellitus His hyperglycemia further improved, and his medications for diabetes were decreased. He remained stable after discontinuing all diabetic medications, with a fasting glucose level of 7.5 mmol/L and a hemoglobin A1C of 6.0% (9 months after the initial visit) (Table 1)
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