Continuous Deterioration of Glucose Metabolism in Treatment-Naive Male Patients with Human Immunodeficiency Virus and Treated with Tenofovir Plus Lamivudine Plus Efavirenz for 156 Weeks

Abstract Introduction: The dynamic characteristics of glucose metabolism and its risk factors in people living with human immunodeficiency virus (PLWH) accepted primary treatment with the efavirenz (EFV) plus lamivudine (3TC) plus tenofovir (TDF) (EFV+3TC+TDF) regimen are unclear and warrant investigation.Methods: This study was designed using follow-up study. Sixty-one male treatment-naive PLWH were treated with EFV+3TC+TDF regimen for 156 weeks. The glucose metabolism dynamic characteristics, the main risk factors and the differences among the three CD4+ count groups were analyzed.Result: In treatment-naive male PLWH who accepted treatment with the EFV+3TC+TDF regimen for 156 weeks, a continuous increase in the fasting plasma glucose (FPG) level, the rate of impaired fasting glucose (IFG) and the glycosylated hemoglobin (HbA1c) level were found. These changes were not due to insulin resistance but rather to significantly reduced islet β cell function, according to the homeostasis model assessment of β cell function (HOMA-β). Moreover, the lower the baseline CD4+ T cell count was, the higher the FPG level and the lower the HOMA-β value. Furthermore the main risk factors for the FPG levels were the CD3+CD8+ cell count and viral load (VL), and the factors contributing to the HOMA-β values were the alanine aminotransferase (ALT) level, VL and CD3+CD8+ cell count.Conclusions: These findings provide guidance to clinicians who are monitoring FPG levels closely and are concerned about IFG and decreased islet β cell function during ART with the EFV+3TC+TDF regimen for long-term application.