Incidence and Predictors of Hyperglycemia Among Adults Receiving Dolutegravir-Based Antiretroviral Therapy at Mbarara Regional Referral Hospital HIV Clinic, Uganda: A Retrospective Cohort Study.

IF 2.4 Q4 INFECTIOUS DISEASES

HIV AIDS-Research and Palliative Care Pub Date : 2026-10-02 eCollection Date: 2026-01-01 DOI:10.2147/HIV.S637953

Arinaitwe Medard, Mwesigwa Geoffrey, Asiimwe Derrick, Ikiriza Anthony, Muyindike Winnie, Stephen Asiimwe

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引用次数: 0

Abstract

Background: Dolutegravir (DTG)-based antiretroviral therapy is widely used in sub-Saharan Africa, but routine-care evidence on incident hyperglycemia after DTG initiation or substitution remains limited in southwestern Uganda.

Purpose: To determine the incidence and predictors of documented hyperglycemia among adults receiving DTG-based antiretroviral therapy at Mbarara Regional Referral Hospital.

Patients and methods: We conducted a retrospective cohort study using routine clinical records of adults who initiated or switched to DTG-based ART between 1 January 2019 and 31 December 2023. Documented incident hyperglycemia was defined as fasting glucose ≥7.0 mmol/L or random glucose ≥11.1 mmol/L with documented classic symptoms. Cox proportional hazards regression estimated adjusted hazard ratios (aHRs); age was modeled per 10-year increase. The proportional-hazards assumption was assessed using Schoenfeld residuals.

Results: Of 8,859 adults in the descriptive cohort, 8,856 contributed positive follow-up time. Seventy-four documented hyperglycemia events occurred over 29,157.74 person-years, an incidence rate of 2.54 per 1,000 person-years (95% CI 1.99-3.19). The smoothed hazard increased after DTG initiation/substitution, peaked at approximately 1.1 years, and declined thereafter. Higher hazard was associated with older age (per 10 years: aHR 1.70, 95% CI 1.33-2.18), prior thymidine analogue NRTI exposure (aHR 3.27, 95% CI 1.20-8.89), and ≥15 years of ART before DTG (aHR 5.63, 95% CI 1.39-22.77). The global proportional-hazards test was not significant (p=0.70).

Conclusion: Documented hyperglycemia was uncommon but was associated with older age and markers of long-term ART exposure. Risk-stratified glucose monitoring should be considered, particularly during the first year after DTG initiation/substitution and among higher-risk patients.

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在乌干达Mbarara地区转诊医院HIV诊所接受多曲地韦抗逆转录病毒治疗的成人中高血糖的发病率和预测因素：一项回顾性队列研究

背景：以多替格拉韦（DTG）为基础的抗逆转录病毒治疗在撒哈拉以南非洲广泛使用，但在乌干达西南部，DTG启动或替代后发生高血糖的常规护理证据仍然有限。目的：确定在Mbarara地区转诊医院接受dtg抗逆转录病毒治疗的成人中记录的高血糖的发生率和预测因素。患者和方法：我们进行了一项回顾性队列研究，使用了2019年1月1日至2023年12月31日期间开始或转向基于dtg的ART的成年人的常规临床记录。有记录的高血糖事件定义为空腹血糖≥7.0 mmol/L或随机血糖≥11.1 mmol/L并有记录的经典症状。Cox比例风险回归估计校正风险比（aHRs）；年龄以每10年增长为模型。比例风险假设采用舍恩菲尔德残差进行评估。结果：在描述性队列的8,859名成年人中，8,856名提供了积极的随访时间。在29157.74人/年的研究中发生了74例高血糖事件，发病率为2.54 / 1000人/年（95% CI 1.99-3.19）。平滑危害在DTG起始/取代后增加，在约1.1年时达到峰值，此后下降。较高的风险与年龄较大（每10年：aHR 1.70, 95% CI 1.33-2.18）、既往胸苷类似物NRTI暴露（aHR 3.27, 95% CI 1.20-8.89）和DTG前ART≥15年（aHR 5.63, 95% CI 1.39-22.77）相关。总体比例风险检验不显著（p=0.70）。结论：记录在案的高血糖并不常见，但与年龄和长期ART暴露标志物有关。应考虑风险分层血糖监测，特别是在DTG开始/替代后的第一年和高风险患者中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

HIV AIDS-Research and Palliative Care INFECTIOUS DISEASES-

CiteScore

3.00

自引率

6.70%

发文量

审稿时长

16 weeks

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