Dolutegravir Associated glycaemia Among Persons with HIV on Treatment at a Kenyan Referral Hospital

Abstract

Background: Dolutegravir-based antiretroviral therapy is a clinically proven treatment option for persons living with the human immunodeficiency virus. However, there is emerging clinical evidence that its use may result in hyperglycaemia, but there is limited data in Africa.
Objectives: To determine the prevalence of dolutegravir-associated hyperglycaemia and its covariates among Persons Living with HIV on treatment in a tertiary teaching and referral hospital in Kenya
Methods: A cross-sectional study was undertaken among adult patients who had been using dolutegravir-based regimens for at least 3 months at the comprehensive care centre in Kenyatta National Hospital. An interviewer-administered questionnaire was used to collect sociodemographic characteristics while clinical data (viral load, CD4 count) were abstracted from patients’ charts. Blood samples were taken to determine random blood sugar and glycated haemoglobin levels. Data were analysed using STATA® statistical software. Associations between hyperglycaemia and patients’ sociodemographic and/or clinical data were determined as appropriate whereas the independent correlates of hyperglycaemia were determined through multivariable logistic regression at P≤.05.
Results: We recruited 358 participants all on dolutegravir based therapy and predominantly female (62.0%). Median age was 444 (IQR 38 to 50) years. Prevalence of hyperglycaemia was 55.9%. Age above 40 years (aOR1.7; 95% CI, 1.1 to 2.7; P=.026), being overweight (aOR 1.7; 95% CI, 1.1 to 2.8; P=.026) and obesity (aOR 3.1; 95% CI, 1.7 to 5.5; P<.001) were associated with experiencing hyperglycaemia.
Conclusion: Dolutegravir-based regimens are associated with hyperglycaemia among patients with advanced age and elevated body mass indices.