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Science","award":["UL1TR000445"],"award-info":[{"award-number":["UL1TR000445"]}],"id":[{"id":"https:\/\/ror.org\/02vm5rt34","id-type":"ROR","asserted-by":"crossref"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Integrase strand transfer inhibitor (INSTI)\u2013based combination antiretroviral therapy (cART) is associated with greater weight gain among persons with human immunodeficiency virus (HIV), though metabolic consequences, such as diabetes mellitus (DM), are unclear. We examined the impact of initial cART regimen and weight on incident DM in a large North American HIV cohort (NA-ACCORD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>cART-naive adults (\u226518 years) initiating INSTI-, protease inhibitor (PI)\u2013, or nonnucleoside reverse transcriptase inhibitor (NNRTI)\u2013based regimens from January 2007 through December 2017 who had weight measured 12 (\u00b16) months after treatment initiation contributed time until clinical DM, virologic failure, cART regimen switch, administrative close, death, or loss to follow-up. Multivariable Cox regression yielded adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for incident DM by cART class. Mediation analyses, with 12-month weight as mediator, similarly adjusted for all covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 22\u2005884 eligible individuals, 47% started NNRTI-, 30% PI-, and 23% INSTI-based cART with median follow-up of 3.0, 2.3, and 1.6 years, respectively. Overall, 722 (3%) developed DM. Persons starting INSTIs vs NNRTIs had incident DM risk (HR, 1.17 [95% CI, .92\u20131.48]), similar to PI vs NNRTI initiators (HR, 1.27 [95% CI, 1.07\u20131.51]). This effect was most pronounced for raltegravir (HR, 1.42 [95% CI, 1.06\u20131.91]) vs NNRTI initiators. The INSTI\u2013DM association was attenuated (HR, 1.03 [95% CI, .71\u20131.49] vs NNRTIs) when accounting for 12-month weight.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Initiating first cART regimens with INSTIs or PIs vs NNRTIs may confer greater risk of DM, likely mediated through weight gain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaa1403","type":"journal-article","created":{"date-parts":[[2020,9,14]],"date-time":"2020-09-14T15:13:46Z","timestamp":1600096426000},"page":"e2234-e2242","source":"Crossref","is-referenced-by-count":102,"title":["Risk of Incident Diabetes Mellitus, Weight Gain, and Their Relationships With Integrase Inhibitor\u2013Based Initial Antiretroviral Therapy Among Persons With Human Immunodeficiency Virus in the United States and Canada"],"prefix":"10.1093","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1951-9104","authenticated-orcid":false,"given":"Peter F","family":"Rebeiro","sequence":"first","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathy A","family":"Jenkins","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aihua","family":"Bian","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan E","family":"Lake","sequence":"additional","affiliation":[{"name":"University of Texas Health Science Center at Houston, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kassem","family":"Bourgi","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine, Indianapolis, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard D","family":"Moore","sequence":"additional","affiliation":[{"name":"Johns Hopkins University, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A","family":"Horberg","sequence":"additional","affiliation":[{"name":"Mid-Atlantic Permanente Research Institute, Rockville, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W Christopher","family":"Matthews","sequence":"additional","affiliation":[{"name":"University of California, San Diego, San Diego, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J","family":"Silverberg","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Northern California, Oakland, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Thorne","sequence":"additional","affiliation":[{"name":"Johns Hopkins University, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angel M","family":"Mayor","sequence":"additional","affiliation":[{"name":"Retrovirus Research Center, Universidad Central del Caribe, Bayam\u00f3n, Puerto Rico, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viviane D","family":"Lima","sequence":"additional","affiliation":[{"name":"University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Frank J","family":"Palella","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S","family":"Saag","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham, Birmingham, Alabama, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keri N","family":"Althoff","sequence":"additional","affiliation":[{"name":"Johns Hopkins University, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M John","family":"Gill","sequence":"additional","affiliation":[{"name":"University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cherise","family":"Wong","sequence":"additional","affiliation":[{"name":"Johns Hopkins University, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina B","family":"Klein","sequence":"additional","affiliation":[{"name":"McGill University, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi M","family":"Crane","sequence":"additional","affiliation":[{"name":"University of Washington, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent C","family":"Marconi","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan E","family":"Shepherd","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy R","family":"Sterling","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R","family":"Koethe","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville, Tennessee, USA"},{"name":"Veterans Affairs Tennessee Valley 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