Diabetes in People with HIV

Sarkar, Sudipa; Brown, Todd T.

doi:10.1007/s11892-021-01382-8

Cited by 40 publications

(34 citation statements)

References 70 publications

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“…The higher the blood sugar levels, the higher the level of glycosylated hemoglobin, in all patients in the studied cohort (DRV/r + DRV/c). Although, nowadays, the PLWH live longer than they did 30 years ago, they have several unique risk factors for metabolic disorder, including diabetes: ART, older generations of protease inhibitors or reverse transcriptase inhibitors, weight gain, lipodystrophy, and co-infection with VHC [34].…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Tolerability and Impact on Metabolic Profiles of Antiretroviral Regimens Containing Darunavir/Ritonavir or Darunavir/Cobicistat in Romanian HIV Infected Patients

et al. 2021

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The management of the side effects caused by the antiretroviral therapy is one of the main problems facing clinicians. The patient’s tolerability and safety influence the success of the therapy. This retrospective study assesses the tolerability and impact on metabolic profiles of antiretroviral regimens containing darunavir/ritonavir (DRV/r) versus those containing darunavir/cobicistat (DRV/c), in routine clinical practice. The database of Prof. Dr Matei Bals of the National Institute of Infectious Diseases (INBI MB) was studied for the period 2017–2020, allowing the inclusion in the study of 462 HIV-infected patients who received the current regimen at least three months before evaluation. The following parameters were collected and analyzed: significant medical history, associated diseases, serum levels for profile evaluation: carbohydrate, lipidic, serum level of liver and pancreatic enzymes, serum markers of cardiac function, coagulation, and renal function. DRV/c (800 mg/150 mg, once daily) administrated in combination with other antiretroviral (ARV) in HIV-1 infected subjects proved to be better tolerated and with a lower impact on metabolic profile than DRV/r (600 mg/100 mg, twice daily). Patients in DRV/r group are significantly more at risk of developing, over time, side effects and metabolic impairments than those in DRV/c group, in all body functions studied, with statistically significant differences (p < 0.05) between the two groups. Laboratory data were correlated with patient’s demographic and clinical characteristics and statistically significant outcomes have been found, proving that a personalized regimen is needed to minimize the ART side effects and to maximize the success of therapy. The results of the study showed that DRV/c, associated with other antiretroviral drugs in the regimens of Romanian HIV infected subjects, have a more favorable metabolic profile than those containing DRV/r.

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Section: Discussionmentioning

confidence: 99%

“…The mechanism is related to the impairment of glucose the transport by therapy, and/or the influence of intracellular glucose phosphorylation. Hyperglycemia occurs frequently in regimens containing protease inhibitors [34,36].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Tolerability and Impact on Metabolic Profiles of Antiretroviral Regimens Containing Darunavir/Ritonavir or Darunavir/Cobicistat in Romanian HIV Infected Patients

et al. 2021

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“…Diabetes is one of the leading causes of comorbidity among PLWH. This may also be a risk factor for the incidence of other cardiometabolic diseases [9,25]. The etiologies of diabetes in PLWH are multifactorial [26][27][28][29].…”

Section: Introductionmentioning

confidence: 99%

Pancreatogenic Diabetes: Triggering Effects of Alcohol and HIV

New-Aaron

Ganesan

Dagur

et al. 2021

Biology

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Multiorgan failure may not be completely resolved among people living with HIV despite HAART use. Although the chances of organ dysfunction may be relatively low, alcohol may potentiate HIV-induced toxic effects in the organs of alcohol-abusing, HIV-infected individuals. The pancreas is one of the most implicated organs, which is manifested as diabetes mellitus or pancreatic cancer. Both alcohol and HIV may trigger pancreatitis, but the combined effects have not been explored. The aim of this review is to explore the literature for understanding the mechanisms of HIV and alcohol-induced pancreatotoxicity. We found that while premature alcohol-inducing zymogen activation is a known trigger of alcoholic pancreatitis, HIV entry through C-C chemokine receptor type 5(CCR5)into pancreatic acinar cells may also contribute to pancreatitis in people living with HIV (PLWH). HIV proteins induce oxidative and ER stresses, causing necrosis. Furthermore, infiltrative immune cells induce necrosis on HIV-containing acinar cells. When necrotic products interact with pancreatic stellate cells, they become activated, leading to the release of both inflammatory and profibrotic cytokines and resulting in pancreatitis. Effective therapeutic strategies should block CCR5 and ameliorate alcohol’s effects on acinar cells.

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“…Approximately 10–15% of people living with HIV (PLWH) also have a diagnosis of type 2 diabetes mellitus (T2DM) (Hernandez-Romieu et al, 2017). PLWH are at increased risk of developing diabetes, due in part to low levels of chronic inflammation and mitochondrial damage from HIV treatment (Hadigan & Kattakuzhy, 2014; Sarkar & Brown, 2021). The prevalence of T2DM in PLWH is expected to increase over the next several years partially due to the aging of PLWH and general diabetes trends in the U.S. that show a growing prevalence of T2DM as people age (Hasse et al, 2011; Kalra et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Counting, Coping, and Navigating the Flux: A Focused Ethnographic Study of HIV and Diabetes Self-Management

2021

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Approximately 10–15% of people living with HIV are also diagnosed with diabetes. To manage their two chronic conditions, people must undertake certain activities and adopt behaviors. Due to overlapping symptoms, complex medication regimens, and heavy patient workloads, implementing these self-management practices can be difficult. In this focused ethnography, data were collected from semi-structured interviews and limited participant-observation with a selected subset of participants to gain insight into self-management challenges and facilitators. We conducted interviews and multiple observations with 22 participants with HIV+T2DM over the period of 9 months. Participants experienced numerous barriers to self-management in the areas of diet, medication adherence, and mental health. Social and familial support, as well as consistent access to care, were facilitators for optimal self-management. At the same time participants’ lives were in a unique flux shaped by the dual diagnoses, and therefore, required constant mental and physical adjustments, thus illustrating challenges of managing chronicity.

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Diabetes in People with HIV

Cited by 40 publications

References 70 publications

Comparison of Tolerability and Impact on Metabolic Profiles of Antiretroviral Regimens Containing Darunavir/Ritonavir or Darunavir/Cobicistat in Romanian HIV Infected Patients

Comparison of Tolerability and Impact on Metabolic Profiles of Antiretroviral Regimens Containing Darunavir/Ritonavir or Darunavir/Cobicistat in Romanian HIV Infected Patients

Pancreatogenic Diabetes: Triggering Effects of Alcohol and HIV

Counting, Coping, and Navigating the Flux: A Focused Ethnographic Study of HIV and Diabetes Self-Management

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