Glucose metabolism changes in Ugandan HIV patients on dolutegravir
Abstract
There has been improved survival of HIV patients in sub-Saharan Africa where the HIV incidence and prevalence is notably high. This could be attributed to the scale up of ART programs and improved anti-retroviral therapy (ART) efficacy. With aging and cumulative side effects of ART, the burden of non-communicable diseases (NCDs) in people living with HIV (PLHIV) has been on the rise. Multiple countries moved to adopt integrase strand inhibitor (INSTI) based ART, particularly DTG containing regimens with the majority of low-middle income countries (LMIC) adopting DTG based ART as the preferred first line therapy. Despite the good side effect profile, DTG has been linked with incident accelerated hyperglycaemia and worsening hyperglycaemia in patients with diabetes. Large population cohort studies however have been contradictory on the association between INSTIs and hyperglycemia. In the proposed studies, we hope to pool data in a meta-analysis to determine if there is indeed an association between INSTI use with insulin resistance and incident diabetes. To further explore this association, a prospective cohort of 303 Ugandan HIV patients on dolutegravir, recruited between February – 2021 and September - 2021 is being followed up for 48 weeks with serial blood glucose and insulin kinetic measurements i.e., insulin secretion at fasting state, insulin secretion at non-fasting state, insulin sensitivity and insulin clearance. We plan to describe glucose metabolism changes in this cohort for 48 weeks. Additionally, we shall compare insulin kinetic trajectories in patients with incident hyperglycemia and those without as well as characterize changes in insulin kinetics after with-holding dolutegravir in patients with incident diabetes. We believe these data will inform surveillance and diabetes treatment strategies in this group of patients.
Funding(s)
- NIH-Fogarty University of California (UCSF) global health fellowship program
- the National Institutes of Health, UCSF-Gladstone Center for AIDS Research
- the Fogarty International Center of the National Institutes of Health
Researcher(s)
- Frank Mulindwa (PhD student at GHI) supervised by Nele Brusselaers
- Other (external) supervisors: Barbara Castelnuovo (Makerere University), Prof. Jean-Marc Schwarz (University of California) and Prof. Robert Bollinger (Johns Hopkins Bloomberg School of Public Health)
Partners
- Makerere University Infectious Diseases Institute
- University of California, San Fransisco
Period
2020 - 2023
Scaling-up Packages of Interventions for Cardiovascular disease prevention in selected sites in Europe and Sub-Saharan Africa: An implementation research (SPICES)
Abstract
The overall research objective of the SPICES project is to implement and evaluate a comprehensive CVD prevention and control program in five settings: a rural & semi-urban community in a low-income country (Uganda), middle income (South Africa) and vulnerable groups in three high-income countries (Belgium, France and United Kingdom) as well as to identify and compare the barriers and facilitators across study contexts. The project will be evaluated using a mix of qualitative and quantitative methods. At the beginning of the project, we will conduct baseline assessments including literature reviews, formative studies, household surveys (where feasible) and learn lessons from other projects to understand healthcare and lifestyle practices, barriers, and facilitators. A costeffectiveness and cost benefit analysis will be included. In addition, the teams will conduct site exchanges visits to learn from each other and organise policy dialogues to ensure sustainability and maximise impact of the interventions.
Funding(s)
Researcher(s)
- Principal investigator: Bastiaens Hilde
- Co-principal investigator: Anthierens Sibyl
- Co-principal investigator: Van geertruyden Jean-Pierre
- Co-principal investigator: Van Royen Paul
Research team(s)
Primary and interdisciplinary care Antwerp (ELIZA)
Period
01/01/2017 -31/12/2021
Website
The relevance of the family in adressing food, health and environment insecurity.
Abstract
Funding(s)
FED. INST.
Researcher(s)
Principal investigator: Van geertruyden Jean-Pierre
Period
01/04/2013-31/03/2019
Website
Joining efforts to detect and control Plasmodium falciparum resistance in East and Central Africa.
Abstract
This project represents a formal research agreement between UA and on the other hand VLIR. UA provides VLIR research results mentioned in the title of the project under the conditions as stipulated in this contract.
Funding(s)
VLIR
Researcher(s)
Principal investigator: Van geertruyden Jean-Pierre
Period
01/07/2014-30/06/2016