Protease inhibitor-based antiretroviral therapy and glucose tolerance in pregnancy: AIDS Clinical Trials Group A5084.
OBJECTIVE
The objective of the study was to determine whether protease inhibitors increase glucose intolerance and insulin resistance in pregnancy.


METHODS
In this multicenter, prospective, observational study, 149 human immunodeficiency virus-1-infected pregnant women had fasting insulin, glucose, and C-peptide measured followed by a 1 hour, 50 g glucose test. Glucose intolerance was defined as a 1 hour glucose greater than 130 mg/dL. Glucose intolerance, homeostasis model assessment of insulin resistance and pancreatic beta-cell function, and pregnancy outcomes were compared between those taking protease inhibitors and those not.


RESULTS
Fifty-seven of 149 subjects (38%) had glucose intolerance. Body mass index, Hispanic ethnicity, and maternal age, but not protease inhibitors, were associated with glucose intolerance. There were no differences in insulin resistance, beta-cell function, or pregnancy outcome associated with protease inhibitor use.


CONCLUSIONS
Protease inhibitors do not increase risk of glucose intolerance or insulin resistance among pregnant women.
Hitti
Jane
J
University of Washington, Seattle, WA, USA.
Andersen
Janet
J
McComsey
Grace
G
Liu
Tun
T
Melvin
Ann
A
Smith
Laura
L
Stek
Alice
A
Aberg
Judith
J
Hull
Andrew
A
Alston-Smith
Beverly
B
Watts
D Heather
DH
Livingston
Elizabeth
E
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose; D016640:Diabetes, Gestational / Q000517:prevention & control; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D018149:Glucose Intolerance; D005951:Glucose Tolerance Test; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000188:drug therapy*; D011256:Pregnancy Outcome; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric
D001786:Blood Glucose; D017320:HIV Protease Inhibitors