Changes in blood pressure, glucose levels, insulin secretion and anthropometry after long term exposure to antiretroviral therapy in South African women

 

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dc.contributor.author Abrahams, Zulfa
dc.contributor.author Dave, Joel A
dc.contributor.author Maartens, Gary
dc.contributor.author Levitt, Naomi S
dc.date.accessioned 2015-08-12T06:34:52Z
dc.date.available 2015-08-12T06:34:52Z
dc.date.issued 2015-08-05
dc.identifier.citation Abrahams, Z., Dave, J. A., Maartens, G., & Levitt, N. S. (2015). Changes in blood pressure, glucose levels, insulin secretion and anthropometry after long term exposure to antiretroviral therapy in South African women. AIDS research and therapy, 12(1), 24.
dc.identifier.uri http://hdl.handle.net/11427/13721
dc.identifier.uri http://dx.doi.org/10.1186/s12981-015-0065-8
dc.description.abstract Abstract Background A number of metabolic abnormalities, such as dysglycaemia, insulin resistance, lipodystrophy and dyslipidaemia, are associated with the use of antiretroviral drugs. We aimed to assess the effects of long-term antiretroviral exposure on blood pressure, glycaemia, insulin secretion and anthropometric measures in black South African women. Methods A convenience sample of HIV-infected women on first-line ART for a median of 16 months at baseline, had the following evaluations twice, at baseline and after approximately 5 years: anthropometry, including skin fold thicknesses, blood pressure, oral glucose test, and insulin. Insulin sensitivity and secretion (HOMA-IR, IGI and DIo) were estimated. Results At baseline more than half the 103 women were using stavudine and efavirenz. The median interval between baseline and follow-up evaluation was 66 months. Weight, waist circumference, and waist-hip ratio increased over time, while limb skinfold thickness decreased over time. Systolic and diastolic blood pressure increased significantly and the proportion of participants with hypertension increased from 3.9 to 15.5% (p < 0.001). There were increases from baseline in plasma glucose concentrations at 30 and 120 min; insulin concentrations at 0 and 30 min; and IGI and DIo. The proportion of participants with diabetes increased from 1 to 7.5% (p = 0.070). Conclusion In black South African women with long-term exposure to ART, increases in hypertension and possibly diabetes were observed. Participants experienced an increase in central fat and a decrease in peripheral fat distribution. Early identification and management of these metabolic changes are important, especially in a region with the highest HIV-infected population in the world.
dc.rights This is an Open Access article distributed under the terms of the Creative Commons Attribution License *
dc.rights.uri http://creativecommons.org/licenses/by/4.0 *
dc.source AIDS Research and Therapy en_ZA
dc.source.uri http://www.aidsrestherapy.com
dc.subject.other HIV en_ZA
dc.subject.other Dysglycaemia en_ZA
dc.subject.other Hypertension en_ZA
dc.subject.other Antiretroviral therapy en_ZA
dc.subject.other Body composition en_ZA
dc.subject.other Lipoatrophy en_ZA
dc.subject.other Blood pressure en_ZA
dc.title Changes in blood pressure, glucose levels, insulin secretion and anthropometry after long term exposure to antiretroviral therapy in South African women
dc.type Journal Article en_ZA
dc.date.updated 2015-08-05T18:02:30Z
dc.language.rfc3066 en
dc.rights.holder Abrahams et al.
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Division of Endocrinology and Diabetology en_ZA
uct.type.filetype
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Abrahams, Z., Dave, J. A., Maartens, G., & Levitt, N. S. (2015). Changes in blood pressure, glucose levels, insulin secretion and anthropometry after long term exposure to antiretroviral therapy in South African women. <i>AIDS Research and Therapy</i>, http://hdl.handle.net/11427/13721 en_ZA
dc.identifier.chicagocitation Abrahams, Zulfa, Joel A Dave, Gary Maartens, and Naomi S Levitt "Changes in blood pressure, glucose levels, insulin secretion and anthropometry after long term exposure to antiretroviral therapy in South African women." <i>AIDS Research and Therapy</i> (2015) http://hdl.handle.net/11427/13721 en_ZA
dc.identifier.vancouvercitation Abrahams Z, Dave JA, Maartens G, Levitt NS. Changes in blood pressure, glucose levels, insulin secretion and anthropometry after long term exposure to antiretroviral therapy in South African women. AIDS Research and Therapy. 2015; http://hdl.handle.net/11427/13721. en_ZA
dc.identifier.ris TY - Journal Article AU - Abrahams, Zulfa AU - Dave, Joel A AU - Maartens, Gary AU - Levitt, Naomi S AB - Abstract Background A number of metabolic abnormalities, such as dysglycaemia, insulin resistance, lipodystrophy and dyslipidaemia, are associated with the use of antiretroviral drugs. We aimed to assess the effects of long-term antiretroviral exposure on blood pressure, glycaemia, insulin secretion and anthropometric measures in black South African women. Methods A convenience sample of HIV-infected women on first-line ART for a median of 16 months at baseline, had the following evaluations twice, at baseline and after approximately 5 years: anthropometry, including skin fold thicknesses, blood pressure, oral glucose test, and insulin. Insulin sensitivity and secretion (HOMA-IR, IGI and DIo) were estimated. Results At baseline more than half the 103 women were using stavudine and efavirenz. The median interval between baseline and follow-up evaluation was 66 months. Weight, waist circumference, and waist-hip ratio increased over time, while limb skinfold thickness decreased over time. Systolic and diastolic blood pressure increased significantly and the proportion of participants with hypertension increased from 3.9 to 15.5% (p < 0.001). There were increases from baseline in plasma glucose concentrations at 30 and 120 min; insulin concentrations at 0 and 30 min; and IGI and DIo. The proportion of participants with diabetes increased from 1 to 7.5% (p = 0.070). Conclusion In black South African women with long-term exposure to ART, increases in hypertension and possibly diabetes were observed. Participants experienced an increase in central fat and a decrease in peripheral fat distribution. Early identification and management of these metabolic changes are important, especially in a region with the highest HIV-infected population in the world. DA - 2015-08-05 DB - OpenUCT DO - 10.1186/s12981-015-0065-8 DP - University of Cape Town J1 - AIDS Research and Therapy LK - https://open.uct.ac.za PB - University of Cape Town PY - 2015 T1 - Changes in blood pressure, glucose levels, insulin secretion and anthropometry after long term exposure to antiretroviral therapy in South African women TI - Changes in blood pressure, glucose levels, insulin secretion and anthropometry after long term exposure to antiretroviral therapy in South African women UR - http://hdl.handle.net/11427/13721 ER - en_ZA


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