Protease inhibitor-based antiretroviral therapy and glucose tolerance in pregnancy: AIDS Clinical Trials Group A5084

Am J Obstet Gynecol. 2007 Apr;196(4):331.e1-7. doi: 10.1016/j.ajog.2006.11.037.

Abstract

Objective: The objective of the study was to determine whether protease inhibitors increase glucose intolerance and insulin resistance in pregnancy.

Study design: 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.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Blood Glucose
  • Diabetes, Gestational / prevention & control
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Gestational Age
  • Glucose Intolerance
  • Glucose Tolerance Test
  • HIV Infections / diagnosis
  • HIV Infections / drug therapy*
  • HIV Protease Inhibitors / therapeutic use*
  • Humans
  • Infant, Newborn
  • Logistic Models
  • Pregnancy
  • Pregnancy Complications, Infectious / diagnosis
  • Pregnancy Complications, Infectious / drug therapy*
  • Pregnancy Outcome*
  • Probability
  • Prospective Studies
  • Risk Assessment
  • Statistics, Nonparametric

Substances

  • Blood Glucose
  • HIV Protease Inhibitors