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Impaired Glucose Tolerance Frequent Among HIV-Infected Pregnant Women: Presented at CROI

By Ed Susman

DENVER, CO -- February 10, 2006 -- Researchers say that HIV-infected pregnant women appear to be at high risk for impaired glucose tolerance, but it does not appear that the risk is tied to whether they are on protease inhibitor-based or other antiretroviral therapy.

"We found no differences between groups of women on protease inhibitors and those taking other antiretrovirals," said Jane Hitti, MD, associate professor of perinatal medicine, obstetrics and gynecology, University of Washington, Seattle, Washington.

However, Dr. Hitti and her colleagues in the AIDS Clinical Trials Group A5084 did find that about 62% of the 149 women in the study were suffering from impaired glucose intolerance or gestational diabetes. She said 57 of the women had some form of impaired glucose tolerance.

Although impaired glucose tolerance has been associated with protease inhibitor-based highly active antiretroviral therapy (HAART), Dr. Hitti saw little difference between the 76 women who were taking protease inhibitors and 73 taking other medications. The women in the study were most frequently using nelfinavir and lopinavir/ritonavir as their protease inhibitor; nevirapine was the most frequent nonprotease backbone of HAART in the other women.

"We believe that in pregnant HIV women, it is the characteristics of the cohort that are leading to the high rate of glucose intolerance and probably not the antiretrovirals," Dr. Hitti said during a presentation here on February 6^th at the 13^th Conference on Retroviruses and Opportunistic Infections (CROI).

She noted that the women in the study tended to be obese, with a median body mass index of 31 in each group (range 19-48).

The researchers concluded that protease inhibitor-containing antiretroviral therapy was not associated with an increased risk of glucose intolerance in pregnancy or with sequelae of glucose intolerance.

In addition, their research showed that protease inhibitor use was not associated with an increase in preterm birth.

Therefore, they said, protease inhibitor use, in general, appears to be a safe antiretroviral strategy for pregnant women with HIV.


[Presentation title: Effect of Protease Inhibitor-Based Antiretroviral Therapy on Glucose Tolerance in Pregnancy (ACTG A5084). Abstract 711]

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