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Erschienen in: Current HIV/AIDS Reports 3/2018

26.04.2018 | Complications of Antiretroviral Therapy (GA McComsey, Section Editor)

Factors Associated With Insulin Resistance in Adults With HIV Receiving Contemporary Antiretroviral Therapy: a Brief Update

verfasst von: Todd Hulgan

Erschienen in: Current HIV/AIDS Reports | Ausgabe 3/2018

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Abstract

Purpose of Review

This narrative review summarizes recent data on factors associated with insulin resistance (IR) in adults with HIV, including contemporary antiretroviral therapy (ART).

Recent Findings

IR remains common in persons with HIV, even those receiving contemporary ART. Generalized and abdominal obesity and ectopic fat are correlates of IR, and emerging data have identified associations with biomarkers of inflammation and immune activation. Small studies suggest associations between mitochondria and IR. In ART-naïve individuals, IR increased within 4 weeks of starting ART in persons receiving contemporary boosted protease inhibitors or an integrase inhibitor.

Summary

The importance of IR in non-diabetic persons with HIV will continue to grow as the population ages and obesity increases. Non-invasive estimates of IR appear to perform well in persons with HIV, but clinically relevant cutoffs are uncertain. Unexpected metabolic effects of newer HIV integrase inhibitors have been reported; thus, careful observation for and studies of IR are still warranted.
Literatur
1.
Zurück zum Zitat Brinkman K, Smeitink JA, Romijn JA, Reiss P. Mitochondrial toxicity induced by nucleoside-analogue reverse-transcriptase inhibitors is a key factor in the pathogenesis of antiretroviral-therapy-related lipodystrophy. Lancet. 1999;354(9184):1112–5.PubMedCrossRef Brinkman K, Smeitink JA, Romijn JA, Reiss P. Mitochondrial toxicity induced by nucleoside-analogue reverse-transcriptase inhibitors is a key factor in the pathogenesis of antiretroviral-therapy-related lipodystrophy. Lancet. 1999;354(9184):1112–5.PubMedCrossRef
2.
Zurück zum Zitat Dalakas MC, Illa I, Pezeshkpour GH, Laukaitis JP, Cohen B, Griffin JL. Mitochondrial myopathy caused by long-term zidovudine therapy. N Engl J Med. 1990;322(16):1098–105.PubMedCrossRef Dalakas MC, Illa I, Pezeshkpour GH, Laukaitis JP, Cohen B, Griffin JL. Mitochondrial myopathy caused by long-term zidovudine therapy. N Engl J Med. 1990;322(16):1098–105.PubMedCrossRef
3.
Zurück zum Zitat Finkle HI. Hepatic mitochondrial toxicity from nucleoside analog therapy. Arch Pathol Lab Med. 1999;123(3):189.PubMed Finkle HI. Hepatic mitochondrial toxicity from nucleoside analog therapy. Arch Pathol Lab Med. 1999;123(3):189.PubMed
4.
Zurück zum Zitat Le Bras P, D'Oiron R, Quertainmont Y, Halfon P, Caquet R. Metabolic, hepatic and muscular changes during zidovudine therapy: a drug-induced mitochondrial disease? AIDS. 1994;8(5):716–7.PubMedCrossRef Le Bras P, D'Oiron R, Quertainmont Y, Halfon P, Caquet R. Metabolic, hepatic and muscular changes during zidovudine therapy: a drug-induced mitochondrial disease? AIDS. 1994;8(5):716–7.PubMedCrossRef
5.
Zurück zum Zitat Nolan D. Metabolic complications associated with HIV protease inhibitor therapy. Drugs. 2003;63(23):2555–74.PubMedCrossRef Nolan D. Metabolic complications associated with HIV protease inhibitor therapy. Drugs. 2003;63(23):2555–74.PubMedCrossRef
7.
Zurück zum Zitat Gan SK, Samaras K, Carr A, Chisholm D. Anti-retroviral therapy, insulin resistance and lipodystrophy. Diabetes Obes Metab. 2001;3(2):67–71.PubMedCrossRef Gan SK, Samaras K, Carr A, Chisholm D. Anti-retroviral therapy, insulin resistance and lipodystrophy. Diabetes Obes Metab. 2001;3(2):67–71.PubMedCrossRef
8.
10.
Zurück zum Zitat Bonora E, Kiechl S, Willeit J, Oberhollenzer F, Egger G, Meigs JB, et al. Insulin resistance as estimated by homeostasis model assessment predicts incident symptomatic cardiovascular disease in Caucasian subjects from the general population: the Bruneck study. Diabetes Care. 2007;30(2):318–24. https://doi.org/10.2337/dc06-0919.PubMedCrossRef Bonora E, Kiechl S, Willeit J, Oberhollenzer F, Egger G, Meigs JB, et al. Insulin resistance as estimated by homeostasis model assessment predicts incident symptomatic cardiovascular disease in Caucasian subjects from the general population: the Bruneck study. Diabetes Care. 2007;30(2):318–24. https://​doi.​org/​10.​2337/​dc06-0919.PubMedCrossRef
11.
Zurück zum Zitat •• Brener MI, Post WS, Haberlen SA, Zhang L, Palella FJ Jr, Jacobson LP, et al. Comparison of insulin resistance to coronary atherosclerosis in human immunodeficiency virus infected and uninfected men (from the multicenter AIDS cohort study). Am J Cardiol. 2016;117(6):993–1000. https://doi.org/10.1016/j.amjcard.2015.12.037. Important analysis of IR in MACS affirms higher HOMA-IR in men with HIV than those without, and associations between HOMA-IR and coronary stenosis.PubMedCrossRef •• Brener MI, Post WS, Haberlen SA, Zhang L, Palella FJ Jr, Jacobson LP, et al. Comparison of insulin resistance to coronary atherosclerosis in human immunodeficiency virus infected and uninfected men (from the multicenter AIDS cohort study). Am J Cardiol. 2016;117(6):993–1000. https://​doi.​org/​10.​1016/​j.​amjcard.​2015.​12.​037. Important analysis of IR in MACS affirms higher HOMA-IR in men with HIV than those without, and associations between HOMA-IR and coronary stenosis.PubMedCrossRef
12.
Zurück zum Zitat Valcour V, Rubin LH, Tien P, Anastos K, Young M, Mack W, et al. Human immunodeficiency virus (HIV) modulates the associations between insulin resistance and cognition in the current combination antiretroviral therapy (cART) era: a study of the Women’s Interagency HIV Study (WIHS). J Neuro-Oncol. 2015;21(4):415–21. https://doi.org/10.1007/s13365-015-0330-6.CrossRef Valcour V, Rubin LH, Tien P, Anastos K, Young M, Mack W, et al. Human immunodeficiency virus (HIV) modulates the associations between insulin resistance and cognition in the current combination antiretroviral therapy (cART) era: a study of the Women’s Interagency HIV Study (WIHS). J Neuro-Oncol. 2015;21(4):415–21. https://​doi.​org/​10.​1007/​s13365-015-0330-6.CrossRef
15.
Zurück zum Zitat Soumaya K. Molecular mechanisms of insulin resistance in diabetes. Adv Exp Med Biol. 2012;771:240–51.PubMed Soumaya K. Molecular mechanisms of insulin resistance in diabetes. Adv Exp Med Biol. 2012;771:240–51.PubMed
27.
Zurück zum Zitat Hommes MJ, Romijn JA, Endert E, Eeftinck Schattenkerk JK, Sauerwein HP. Insulin sensitivity and insulin clearance in human immunodeficiency virus-infected men. Metabolism. 1991;40(6):651–6.PubMedCrossRef Hommes MJ, Romijn JA, Endert E, Eeftinck Schattenkerk JK, Sauerwein HP. Insulin sensitivity and insulin clearance in human immunodeficiency virus-infected men. Metabolism. 1991;40(6):651–6.PubMedCrossRef
28.
Zurück zum Zitat Mynarcik DC, McNurlan MA, Steigbigel RT, Fuhrer J, Gelato MC. Association of severe insulin resistance with both loss of limb fat and elevated serum tumor necrosis factor receptor levels in HIV lipodystrophy. J Acquir Immune Defic Syndr. 2000;25(4):312–21.PubMedCrossRef Mynarcik DC, McNurlan MA, Steigbigel RT, Fuhrer J, Gelato MC. Association of severe insulin resistance with both loss of limb fat and elevated serum tumor necrosis factor receptor levels in HIV lipodystrophy. J Acquir Immune Defic Syndr. 2000;25(4):312–21.PubMedCrossRef
29.
Zurück zum Zitat Noor MA, Lo JC, Mulligan K, Schwarz JM, Halvorsen RA, Schambelan M, et al. Metabolic effects of indinavir in healthy HIV-seronegative men. AIDS. 2001;15(7):F11–8.PubMedPubMedCentralCrossRef Noor MA, Lo JC, Mulligan K, Schwarz JM, Halvorsen RA, Schambelan M, et al. Metabolic effects of indinavir in healthy HIV-seronegative men. AIDS. 2001;15(7):F11–8.PubMedPubMedCentralCrossRef
30.
Zurück zum Zitat van der Valk M, Bisschop PH, Romijn JA, Ackermans MT, Lange JM, Endert E, et al. Lipodystrophy in HIV-1-positive patients is associated with insulin resistance in multiple metabolic pathways. AIDS. 2001;15(16):2093–100.PubMedCrossRef van der Valk M, Bisschop PH, Romijn JA, Ackermans MT, Lange JM, Endert E, et al. Lipodystrophy in HIV-1-positive patients is associated with insulin resistance in multiple metabolic pathways. AIDS. 2001;15(16):2093–100.PubMedCrossRef
31.
Zurück zum Zitat Gelato MC, Mynarcik DC, Quick JL, Steigbigel RT, Fuhrer J, Brathwaite CE, et al. Improved insulin sensitivity and body fat distribution in HIV-infected patients treated with rosiglitazone: a pilot study. J Acquir Immune Defic Syndr. 2002;31(2):163–70.PubMedCrossRef Gelato MC, Mynarcik DC, Quick JL, Steigbigel RT, Fuhrer J, Brathwaite CE, et al. Improved insulin sensitivity and body fat distribution in HIV-infected patients treated with rosiglitazone: a pilot study. J Acquir Immune Defic Syndr. 2002;31(2):163–70.PubMedCrossRef
33.
Zurück zum Zitat Noor MA, Seneviratne T, Aweeka FT, Lo JC, Schwarz JM, Mulligan K, et al. Indinavir acutely inhibits insulin-stimulated glucose disposal in humans: a randomized, placebo-controlled study. AIDS. 2002;16(5):F1–8.PubMedPubMedCentralCrossRef Noor MA, Seneviratne T, Aweeka FT, Lo JC, Schwarz JM, Mulligan K, et al. Indinavir acutely inhibits insulin-stimulated glucose disposal in humans: a randomized, placebo-controlled study. AIDS. 2002;16(5):F1–8.PubMedPubMedCentralCrossRef
34.
Zurück zum Zitat Bonora E, Targher G, Alberiche M, Bonadonna RC, Saggiani F, Zenere MB, et al. Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity: studies in subjects with various degrees of glucose tolerance and insulin sensitivity. Diabetes Care. 2000;23(1):57–63.PubMedCrossRef Bonora E, Targher G, Alberiche M, Bonadonna RC, Saggiani F, Zenere MB, et al. Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity: studies in subjects with various degrees of glucose tolerance and insulin sensitivity. Diabetes Care. 2000;23(1):57–63.PubMedCrossRef
36.
Zurück zum Zitat Randell PA, Jackson AG, Boffito M, Back DJ, Tjia JF, Taylor J, et al. Effect of boosted fosamprenavir or lopinavir-based combinations on whole-body insulin sensitivity and lipids in treatment-naive HIV-type-1-positive men. Antivir Ther. 2010;15(8):1125–32. https://doi.org/10.3851/imp1675.PubMedCrossRef Randell PA, Jackson AG, Boffito M, Back DJ, Tjia JF, Taylor J, et al. Effect of boosted fosamprenavir or lopinavir-based combinations on whole-body insulin sensitivity and lipids in treatment-naive HIV-type-1-positive men. Antivir Ther. 2010;15(8):1125–32. https://​doi.​org/​10.​3851/​imp1675.PubMedCrossRef
37.
Zurück zum Zitat Woerle HJ, Mariuz PR, Meyer C, Reichman RC, Popa EM, Dostou JM, et al. Mechanisms for the deterioration in glucose tolerance associated with HIV protease inhibitor regimens. Diabetes. 2003;52(4):918–25.PubMedCrossRef Woerle HJ, Mariuz PR, Meyer C, Reichman RC, Popa EM, Dostou JM, et al. Mechanisms for the deterioration in glucose tolerance associated with HIV protease inhibitor regimens. Diabetes. 2003;52(4):918–25.PubMedCrossRef
38.
Zurück zum Zitat Matsuda M, DeFronzo RA. Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp. Diabetes Care. 1999;22(9):1462–70.PubMedCrossRef Matsuda M, DeFronzo RA. Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp. Diabetes Care. 1999;22(9):1462–70.PubMedCrossRef
50.
Zurück zum Zitat •• Nansseu JR, Bigna JJ, Kaze AD, Noubiap JJ. Incidence and risk factors for prediabetes and diabetes mellitus among HIV infected adults on antiretroviral therapy: systematic review and meta-analysis. Epidemiology. 2018. https://doi.org/10.1097/EDE.0000000000000815. Extensive review of incidence and risk factors; very detailed supplemental tables of individual study results are valuable resource. •• Nansseu JR, Bigna JJ, Kaze AD, Noubiap JJ. Incidence and risk factors for prediabetes and diabetes mellitus among HIV infected adults on antiretroviral therapy: systematic review and meta-analysis. Epidemiology. 2018. https://​doi.​org/​10.​1097/​EDE.​0000000000000815​. Extensive review of incidence and risk factors; very detailed supplemental tables of individual study results are valuable resource.
51.
Zurück zum Zitat • McMahon CN, Petoumenos K, Hesse K, Carr A, Cooper DA, Samaras K. High rates of incident diabetes and prediabetes are evident in men with treated HIV followed for 11 years. AIDS. 2018;32(4):451–9. https://doi.org/10.1097/QAD.0000000000001709. Small study, but longest known follow-up of a single cohort with OGTT capturing transitions to pre-diabetes and diabetes.PubMedCrossRef • McMahon CN, Petoumenos K, Hesse K, Carr A, Cooper DA, Samaras K. High rates of incident diabetes and prediabetes are evident in men with treated HIV followed for 11 years. AIDS. 2018;32(4):451–9. https://​doi.​org/​10.​1097/​QAD.​0000000000001709​. Small study, but longest known follow-up of a single cohort with OGTT capturing transitions to pre-diabetes and diabetes.PubMedCrossRef
57.
Zurück zum Zitat • Longenecker CT, Margevicius S, Liu Y, Schluchter MD, Yun CH, Bezerra HG, et al. Effect of pericardial fat volume and density on markers of insulin resistance and inflammation in patients with human immunodeficiency virus infection. Am J Cardiol. 2017;120(8):1427–33. https://doi.org/10.1016/j.amjcard.2017.07.019. Longitudinal analysis demonstrating independent associations between pericardial fat measured by computed tomography and HOMA-IR in persons with HIV.PubMedCrossRefPubMedCentral • Longenecker CT, Margevicius S, Liu Y, Schluchter MD, Yun CH, Bezerra HG, et al. Effect of pericardial fat volume and density on markers of insulin resistance and inflammation in patients with human immunodeficiency virus infection. Am J Cardiol. 2017;120(8):1427–33. https://​doi.​org/​10.​1016/​j.​amjcard.​2017.​07.​019. Longitudinal analysis demonstrating independent associations between pericardial fat measured by computed tomography and HOMA-IR in persons with HIV.PubMedCrossRefPubMedCentral
81.
Zurück zum Zitat Shikuma CM, Day LJ, Gerschenson M. Insulin resistance in the HIV-infected population: the potential role of mitochondrial dysfunction. Curr Drug Targets Infect Disord. 2005;5(3):255–62.PubMedCrossRef Shikuma CM, Day LJ, Gerschenson M. Insulin resistance in the HIV-infected population: the potential role of mitochondrial dysfunction. Curr Drug Targets Infect Disord. 2005;5(3):255–62.PubMedCrossRef
82.
Zurück zum Zitat Hart AB, Samuels DC, Hulgan T. The other genome: a systematic review of studies of mitochondrial DNA haplogroups and outcomes of HIV infection and antiretroviral therapy. AIDS Rev. 2013;15(4):213–20.PubMedPubMedCentral Hart AB, Samuels DC, Hulgan T. The other genome: a systematic review of studies of mitochondrial DNA haplogroups and outcomes of HIV infection and antiretroviral therapy. AIDS Rev. 2013;15(4):213–20.PubMedPubMedCentral
85.
Zurück zum Zitat Hulgan T, Ramsey B, Koethe JR, Samuels DC, Gerschenson M, Libutti D et al. Adipose mitochondrial function, adiponectin, and insulin resistance in ACTG A5224S. Conference on Retroviruses and Opportunistic Infections; February 13–16; Boston, MA, USA; 2017. Hulgan T, Ramsey B, Koethe JR, Samuels DC, Gerschenson M, Libutti D et al. Adipose mitochondrial function, adiponectin, and insulin resistance in ACTG A5224S. Conference on Retroviruses and Opportunistic Infections; February 13–16; Boston, MA, USA; 2017.
87.
Zurück zum Zitat McComsey GA, Daar ES, O'Riordan M, Collier AC, Kosmiski L, Santana JL, et al. Changes in fat mitochondrial DNA and function in subjects randomized to abacavir-lamivudine or tenofovir DF-emtricitabine with atazanavir-ritonavir or efavirenz: AIDS Clinical Trials Group study A5224s, substudy of A5202. J Infect Dis. 2013;207(4):604–11. https://doi.org/10.1093/infdis/jis720.PubMedCrossRef McComsey GA, Daar ES, O'Riordan M, Collier AC, Kosmiski L, Santana JL, et al. Changes in fat mitochondrial DNA and function in subjects randomized to abacavir-lamivudine or tenofovir DF-emtricitabine with atazanavir-ritonavir or efavirenz: AIDS Clinical Trials Group study A5224s, substudy of A5202. J Infect Dis. 2013;207(4):604–11. https://​doi.​org/​10.​1093/​infdis/​jis720.PubMedCrossRef
90.
Zurück zum Zitat Ryom L, Lundgren J, El-Sadr WM, Reiss P, Phillips A, Kirk O et al. Association between cardiovascular disease & contemporarily used protease inhibitors. Conference on Retroviruses and Opportunistic Infections; February 13–16; Boston, MA, USA; 2017. Ryom L, Lundgren J, El-Sadr WM, Reiss P, Phillips A, Kirk O et al. Association between cardiovascular disease & contemporarily used protease inhibitors. Conference on Retroviruses and Opportunistic Infections; February 13–16; Boston, MA, USA; 2017.
94.
95.
Zurück zum Zitat DeJesus E, Rockstroh JK, Henry K, Molina JM, Gathe J, Ramanathan S, et al. Co-formulated elvitegravir, cobicistat, emtricitabine, and tenofovir disoproxil fumarate versus ritonavir-boosted atazanavir plus co-formulated emtricitabine and tenofovir disoproxil fumarate for initial treatment of HIV-1 infection: a randomised, double-blind, phase 3, non-inferiority trial. Lancet. 2012;379(9835):2429–38. https://doi.org/10.1016/s0140-6736(12)60918-0.PubMedCrossRef DeJesus E, Rockstroh JK, Henry K, Molina JM, Gathe J, Ramanathan S, et al. Co-formulated elvitegravir, cobicistat, emtricitabine, and tenofovir disoproxil fumarate versus ritonavir-boosted atazanavir plus co-formulated emtricitabine and tenofovir disoproxil fumarate for initial treatment of HIV-1 infection: a randomised, double-blind, phase 3, non-inferiority trial. Lancet. 2012;379(9835):2429–38. https://​doi.​org/​10.​1016/​s0140-6736(12)60918-0.PubMedCrossRef
96.
Zurück zum Zitat Sax PE, DeJesus E, Mills A, Zolopa A, Cohen C, Wohl D, et al. Co-formulated elvitegravir, cobicistat, emtricitabine, and tenofovir versus co-formulated efavirenz, emtricitabine, and tenofovir for initial treatment of HIV-1 infection: a randomised, double-blind, phase 3 trial, analysis of results after 48 weeks. Lancet. 2012;379(9835):2439–48. https://doi.org/10.1016/s0140-6736(12)60917-9.PubMedCrossRef Sax PE, DeJesus E, Mills A, Zolopa A, Cohen C, Wohl D, et al. Co-formulated elvitegravir, cobicistat, emtricitabine, and tenofovir versus co-formulated efavirenz, emtricitabine, and tenofovir for initial treatment of HIV-1 infection: a randomised, double-blind, phase 3 trial, analysis of results after 48 weeks. Lancet. 2012;379(9835):2439–48. https://​doi.​org/​10.​1016/​s0140-6736(12)60917-9.PubMedCrossRef
100.
Zurück zum Zitat •• Dirajlal-Fargo S, Moser C, Brown TT, Kelesidis T, Dube MP, Stein JH, et al. Changes in insulin resistance after initiation of raltegravir or protease inhibitors with tenofovir-emtricitabine: AIDS Clinical Trials Group A5260s. Open Forum Infect Dis. 2016;3(3):ofw174. https://doi.org/10.1093/ofid/ofw174. Unique targeted analysis of HOMA-IR in a clinical trial of contemporary ART regimens in treatment-naïve persons; HOMA-IR increased rapidly after starting either boosted PI or RAL-containing ART.PubMedPubMedCentralCrossRef •• Dirajlal-Fargo S, Moser C, Brown TT, Kelesidis T, Dube MP, Stein JH, et al. Changes in insulin resistance after initiation of raltegravir or protease inhibitors with tenofovir-emtricitabine: AIDS Clinical Trials Group A5260s. Open Forum Infect Dis. 2016;3(3):ofw174. https://​doi.​org/​10.​1093/​ofid/​ofw174. Unique targeted analysis of HOMA-IR in a clinical trial of contemporary ART regimens in treatment-naïve persons; HOMA-IR increased rapidly after starting either boosted PI or RAL-containing ART.PubMedPubMedCentralCrossRef
103.
Zurück zum Zitat Spinner CD, Kern KE, Zink A, Wolf E, Balogh A, Noe S, et al. Neither boosted elvitegravir nor darunavir with emtricitabine/tenofovir disoproxil fumarate increase insulin resistance in healthy volunteers: results from the STRIBILD-IR study. Antivir Ther. 2016;21(7):627–31. https://doi.org/10.3851/imp3049.PubMedCrossRef Spinner CD, Kern KE, Zink A, Wolf E, Balogh A, Noe S, et al. Neither boosted elvitegravir nor darunavir with emtricitabine/tenofovir disoproxil fumarate increase insulin resistance in healthy volunteers: results from the STRIBILD-IR study. Antivir Ther. 2016;21(7):627–31. https://​doi.​org/​10.​3851/​imp3049.PubMedCrossRef
104.
111.
Zurück zum Zitat Gallant J, Lazzarin A, Mills A, Orkin C, Podzamczer D, Tebas P, et al. Bictegravir, emtricitabine, and tenofovir alafenamide versus dolutegravir, abacavir, and lamivudine for initial treatment of HIV-1 infection (GS-US-380-1489): a double-blind, multicentre, phase 3, randomised controlled non-inferiority trial. Lancet. 2017;390(10107):2063–72. https://doi.org/10.1016/S0140-6736(17)32299-7.PubMedCrossRef Gallant J, Lazzarin A, Mills A, Orkin C, Podzamczer D, Tebas P, et al. Bictegravir, emtricitabine, and tenofovir alafenamide versus dolutegravir, abacavir, and lamivudine for initial treatment of HIV-1 infection (GS-US-380-1489): a double-blind, multicentre, phase 3, randomised controlled non-inferiority trial. Lancet. 2017;390(10107):2063–72. https://​doi.​org/​10.​1016/​S0140-6736(17)32299-7.PubMedCrossRef
112.
Zurück zum Zitat Sax PE, Pozniak A, Montes ML, Koenig E, DeJesus E, Stellbrink H-J, et al. Coformulated bictegravir, emtricitabine, and tenofovir alafenamide versus dolutegravir with emtricitabine and tenofovir alafenamide, for initial treatment of HIV-1 infection (GS-US-380–1490): a randomised, double-blind, multicentre, phase 3, non-inferiority trial. Lancet. 2017;390(10107):2073–82. https://doi.org/10.1016/S0140-6736(17)32340-1.PubMedCrossRef Sax PE, Pozniak A, Montes ML, Koenig E, DeJesus E, Stellbrink H-J, et al. Coformulated bictegravir, emtricitabine, and tenofovir alafenamide versus dolutegravir with emtricitabine and tenofovir alafenamide, for initial treatment of HIV-1 infection (GS-US-380–1490): a randomised, double-blind, multicentre, phase 3, non-inferiority trial. Lancet. 2017;390(10107):2073–82. https://​doi.​org/​10.​1016/​S0140-6736(17)32340-1.PubMedCrossRef
115.
Zurück zum Zitat Perez-Matute P, Perez-Martinez L, Blanco JR, Oteo JA. Neutral actions of raltegravir on adipogenesis, glucose metabolism and lipolysis in 3T3-L1 adipocytes. Curr HIV Res. 2011;9(3):174–9.PubMedCrossRef Perez-Matute P, Perez-Martinez L, Blanco JR, Oteo JA. Neutral actions of raltegravir on adipogenesis, glucose metabolism and lipolysis in 3T3-L1 adipocytes. Curr HIV Res. 2011;9(3):174–9.PubMedCrossRef
Metadaten
Titel
Factors Associated With Insulin Resistance in Adults With HIV Receiving Contemporary Antiretroviral Therapy: a Brief Update
verfasst von
Todd Hulgan
Publikationsdatum
26.04.2018
Verlag
Springer US
Erschienen in
Current HIV/AIDS Reports / Ausgabe 3/2018
Print ISSN: 1548-3568
Elektronische ISSN: 1548-3576
DOI
https://doi.org/10.1007/s11904-018-0399-7

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