Use of Protease Inhibitors Increases Risk of Diabetes in Women, Study Says

HIV-positive women who use protease inhibitors, a class of antiretroviral drugs, are at an increased risk of developing diabetes, according to a study published in the March 1 issue of the Journal of Acquired Immune Deficiency Syndromes, Reuters Health reports (McCook, Reuters Health, 3/21). Study author Dr. Jessica Justman of the Bronx-Lebanon Hospital Center in New York and colleagues examined 1,785 nonpregnant women who had no history of diabetes and divided them into four groups: HIV-positive women who were taking PIs; HIV-positive women who were taking reverse transcriptase inhibitors, another type of antiretroviral drug, but not PIs; HIV-positive women who were not on antiretroviral therapy; and HIV-negative women (Justman et al., JAIDS, 3/1). Most of the women in the study were either African-American or Latina. Approximately 3% of the women who were taking PIs developed diabetes, compared with 1% of women who were not taking that class of drugs. Women taking reverse transcriptase inhibitors were no more likely to develop diabetes than women who were not taking antiretroviral medications. In addition, women who were obese or overweight and who were older were more likely to develop diabetes than other women. The researchers noted that the risk of developing diabetes may be even higher than reported in the study, as the results were based on self reporting of diabetes status, and some women could have been unaware that they had the disease. The researchers do not suggest that women stop using PIs. "PIs are so effective in helping people with AIDS be healthier and live longer, and the risk of diabetes is small, compared to the risk of death without treatment," Justman said. The researchers suggest that doctors offer "routine screening" for patients on PIs, especially older women or those who are obese. The study offered no explanation for why the use of PIs increases diabetes risk, nor why other antiretroviral drugs appear not to increase risk (Reuters Health, 3/21).