The Long-term Effect of Different Combination Therapies on Glucose Metabolism in HIV/Aids Subjects in Cameroon

Abstract

The use of antiretroviral drugs is associated with an increase of metabolic abnormalities such as impaired glucose metabolism and insulin resistance. This study was designed to investigate the long-term effect of antiretroviral combinations therapy on glucose metabolism in HIV/AIDS patients in Cameroon. A descriptive and prospective study was carried out on 58 patients on HAART and 80 pre-HAART patients. The various drugs regimens comprised Lamivudin-Zidovudin associated with Efavirenz (Therapy I n = 9) of Nevirapin (Therapy II n =13) and Stavudin-Lamivudin associated with Nevirapin (Therapy III n =30) of Efavirenz (Therapy IV n =16). All patients were monitored at baseline and then 12 months later. Blood glucose levels increased significantly in both pre-HAART (34.08 +or- 9.93%) and HAART patients (45.56 +or- 7.86%). The mean blood glucose levels increased by 78.19% (p < 0.001) 61.50% (p < 0.0001) 69.96% (p < 0.0001) and 16.92% (p < 0.01) with therapy I II IV and III respectively. The increase was associated with efavirenz or zidovudine use. It is possible that efavirenz or zidovudine use in a combination therapy may exaggerate an underlying tendency to develop mitochondrial toxicity or insulin resistance. (authors)