{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:05:59Z","timestamp":1787313959662,"version":"build-2736575974"},"reference-count":48,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2022,1,19]],"date-time":"2022-01-19T00:00:00Z","timestamp":1642550400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007941","name":"Addis Ababa University","doi-asserted-by":"publisher","award":["GPO\/275\/12\/20"],"award-info":[{"award-number":["GPO\/275\/12\/20"]}],"id":[{"id":"10.13039\/501100007941","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001862","name":"The Swedish Research Council","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001862","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001713","name":"European and Developing countries Clinical Trials Partnership","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001713","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We investigated prevalence and predictors of glucose metabolism disorders (GMDs) among People Living with HIV (PLWH) on efavirenz- and atazanavir\/ritonavir-based combination antiretroviral therapy (cART).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study involved adult PLWH on efavirenz- (n = 240) and atazanavir\/ritonavir-based (n = 111) cART. The prevalence of GMDs was determined by fasting serum glucose, insulin, and homeostasis model assessment. A logistic regression model was used to determine predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The overall prevalence of GMDs for all regimens was 27.6% (97\/351) [95% CI 23.0\u201332.6%] s, with 31.1% (75\/240) [95% CI 25.4\u201337.5%] for efavirenz-based and 19.8% (22\/111) [95% CI 12.9\u201328.5%)] for atazanavir\/ritonavir-based cART group. The prevalence of impaired fasting glycemia was significantly higher (p = 0.026) in the efavirenz- [(15.4%) (37\/240); 95%CI (11.1\u201320.6%)] than atazanavir\/ritonavir-based [(7.2%) (8\/111), (95%CI (3.2\u201313.7%)] cART. However, no significant difference was observed in the prevalence of diabetes mellitus and insulin resistance between the two regimens. Age \u226546 years old and specific type of ARV contained in cART, such as TDF, were independent predictors of GMD in both groups. Whereas the male gender and BMI category were predictors of GMDs among EFV-based cART group, AZT- and ABC- containing regimens and triglyceride levels were predictors in the ATV\/r-based group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>GMDs were highly prevalent among adults on EFV- than ATV\/r-based cARTs. Age \u226546 years and TDF-containing cARTs are common predictors in both regimens. Close monitoring for impaired fasting glucose during long-term EFV-based cART is recommended for early diagnosis of type-2 diabetes and management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0262604","type":"journal-article","created":{"date-parts":[[2022,1,19]],"date-time":"2022-01-19T13:29:15Z","timestamp":1642598955000},"page":"e0262604","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":13,"title":["Prevalence and predictors of glucose metabolism disorders among People Living with HIV on combination antiretroviral therapy"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6143-0387","authenticated-orcid":true,"given":"Wondmagegn Tamiru","family":"Tadesse","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birhanemeskel T.","family":"Adankie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Workineh","family":"Shibeshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wondwossen","family":"Amogne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9788-0790","authenticated-orcid":true,"given":"Eleni","family":"Aklillu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9931-6421","authenticated-orcid":true,"given":"Ephrem","family":"Engidawork","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,1,19]]},"reference":[{"key":"pone.0262604.ref001","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1038\/s41586-019-1200-9","article-title":"Mapping HIV prevalence in sub-Saharan Africa between 2000 and 2017","volume":"570","author":"L Dwyer-Lindgren","year":"2019","journal-title":"Nature"},{"key":"pone.0262604.ref002","doi-asserted-by":"crossref","first-page":"34","DOI":"10.2174\/1874613601610010034","article-title":"HIV Infection and AIDS in Sub-Saharan Africa: Current Status, Challenges and Opportunities","volume":"10","author":"ABM Kharsany","year":"2016","journal-title":"Open AIDS J"},{"key":"pone.0262604.ref003","volume-title":"Highly Active Antiretroviral Therapy (HAART). StatPearls","author":"JS Eggleton","year":"2020"},{"key":"pone.0262604.ref004","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1007\/s00038-017-1023-0","article-title":"Trends in HIV\/AIDS morbidity and mortality in Eastern Mediterranean countries, 1990\u20132015: findings from the Global Burden of Disease 2015 study","volume":"63","author":"C El Bcheraoui","year":"2018","journal-title":"Int J Public Health"},{"key":"pone.0262604.ref005","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1080\/09540121.2015.1074653","article-title":"Lifelong antiretroviral therapy or HIV cure: The benefits for the individual patient","volume":"28","author":"KG Buell","year":"2016","journal-title":"AIDS Care"},{"key":"pone.0262604.ref006","first-page":"507","article-title":"Antiretroviral Therapy-Associated Metabolic Complications: Review of the Recent Studies","volume":"12","author":"D Thet","year":"2020","journal-title":"HIV AIDS (Auckl)"},{"key":"pone.0262604.ref007","doi-asserted-by":"crossref","first-page":"e0134410","DOI":"10.1371\/journal.pone.0134410","article-title":"Glucose Metabolism Disorders, HIV and Antiretroviral Therapy among Tanzanian Adults","volume":"10","author":"E Maganga","year":"2015","journal-title":"PLOS ONE"},{"key":"pone.0262604.ref008","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.diabres.2016.03.012","article-title":"Increased risk of dysglycaemia in South Africans with HIV; especially those on protease inhibitors","volume":"119","author":"NS Levitt","year":"2016","journal-title":"Diabetes Research and Clinical Practice"},{"key":"pone.0262604.ref009","first-page":"12","article-title":"Diabetes mellitus and its associated risk factors in patients with human immunodeficiency virus on anti-retroviral therapy at referral hospitals of Northwest Ethiopia","author":"A Gebrie","year":"2020","journal-title":"Diabetol Metab Syndr"},{"key":"pone.0262604.ref010","doi-asserted-by":"crossref","DOI":"10.1186\/s13098-015-0046-z","article-title":"Insulin resistance by homeostasis model assessment in HIV-infected patients on highly active antiretroviral therapy: cross-sectional study","volume":"7","author":"MA Guillen","year":"2015","journal-title":"Diabetol Metab Syndr"},{"key":"pone.0262604.ref011","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1001\/archinte.165.10.1179","article-title":"Antiretroviral Therapy and the Prevalence and Incidence of Diabetes Mellitus in the Multicenter AIDS Cohort Study","volume":"165","author":"TT Brown","year":"2005","journal-title":"Arch Intern Med"},{"key":"pone.0262604.ref012","first-page":"e7481597","article-title":"Metabolic Disorders in HIV-Infected Adolescents Receiving Protease Inhibitors","author":"J Santiprabhob","year":"2017","journal-title":"BioMed Research International"},{"key":"pone.0262604.ref013","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1097\/01.aids.0000244200.11006.55","article-title":"Effects of atazanavir\/ritonavir and lopinavir\/ritonavir on glucose uptake and insulin sensitivity: demonstrable differences in vitro and clinically","volume":"20","author":"MA Noor","year":"2006","journal-title":"AIDS"},{"key":"pone.0262604.ref014","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1177\/0956462415590724","article-title":"Impact of switching from lopinavir\/ritonavir to boosted and un-boosted atazanavir on glucose metabolism: the ATAzanavir & GLUcose metabolism (ATAGLU) study","volume":"27","author":"G d\u2019Ettorre","year":"2016","journal-title":"Int J STD AIDS"},{"key":"pone.0262604.ref015","doi-asserted-by":"crossref","first-page":"430","DOI":"10.3390\/jcm8040430","article-title":"HIV and cART-Associated Dyslipidemia Among HIV-Infected Children","volume":"8","author":"BT Tadesse","year":"2019","journal-title":"Journal of Clinical Medicine"},{"key":"pone.0262604.ref016","first-page":"217","article-title":"Serum Lipid Profiles of Patients Taking Efavirenz-Based Antiretroviral Regimen Compared to Ritonavir-Boosted Atazanavir with an Optimized Background at Zewditu Memorial Hospital, Addis Ababa, Ethiopia","volume":"13","author":"A Muche Belete","year":"2021","journal-title":"HIV AIDS (Auckl)"},{"key":"pone.0262604.ref017","unstructured":"Ministry of Health of Ethiopia. National consolidated guidelines for comprehensive HIV prevention, care and treatment. 2018 [cited 23 Oct 2021]. In: WHO | Regional Office for Africa. https:\/\/www.afro.who.int\/publications\/national-consolidated-guidelines-comprehensive-hiv-prevention-care-and-treatment."},{"key":"pone.0262604.ref018","article-title":"Achievement of diabetes care goals at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia","volume":"58","author":"H Yifter","year":"2020","journal-title":"EMJ"},{"key":"pone.0262604.ref019","doi-asserted-by":"crossref","first-page":"121","DOI":"10.4103\/0253-7176.116232","article-title":"How to calculate sample size for different study designs in medical research? I","volume":"35","author":"J Charan","year":"2013","journal-title":"ndian J Psychol Med"},{"key":"pone.0262604.ref020","first-page":"440","article-title":"Prevalence of prediabetes in HIV-1 infected adults receiving antiretroviral therapy in Addis Ababa, Ethiopia","volume":"6","author":"HA Gebreyesus","year":"2015","journal-title":"Int J Pharm Sci Res"},{"key":"pone.0262604.ref021","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1186\/s13104-019-4402-1","article-title":"Diabetes mellitus and its associated factors among human immunodeficiency virus-infected patients on anti-retroviral therapy in Northeast Ethiopia","volume":"12","author":"T Fiseha","year":"2019","journal-title":"BMC Research Notes"},{"key":"pone.0262604.ref022","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1310\/JFXH-G3X2-EYM6-D6UG","article-title":"Measuring Adherence to Antiretroviral Therapy in a Diverse Population Using a Visual Analogue Scale","volume":"5","author":"TP Giordano","year":"2004","journal-title":"HIV Clinical Trials"},{"key":"pone.0262604.ref023","doi-asserted-by":"crossref","first-page":"e0203032","DOI":"10.1371\/journal.pone.0203032","article-title":"Evaluation of self-report adherence measures and their associations with detectable viral load among people living with HIV (PLHIV) in China","volume":"13","author":"W Da","year":"2018","journal-title":"PLOS ONE"},{"key":"pone.0262604.ref024","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/2050-6511-15-32","article-title":"Self-reported adverse drug reactions and their influence on highly active antiretroviral therapy in HIV infected patients: a cross sectional study","volume":"15","author":"WT Tadesse","year":"2014","journal-title":"BMC Pharmacology and Toxicology"},{"key":"pone.0262604.ref025","unstructured":"World Health Organization. Waist circumference and waist-hip ratio: report of a WHO expert consultation, Geneva, 2008 Dec 8\u201311. [cited 15 Oct 2021]. https:\/\/apps.who.int\/iris\/handle\/10665\/44583."},{"key":"pone.0262604.ref026","unstructured":"World Health Organization and International Diabetes Federation. Definition and diagnosis of diabetes mellitus and intermediate hyperglycaemia: report of a WHO\/IDF consultation. 2006 [cited 15 Oct 2021]. https:\/\/apps.who.int\/iris\/handle\/10665\/43588."},{"key":"pone.0262604.ref027","unstructured":"WHO. Indicator Metadata Registry Details. In: World Health Organization [Internet]. 2021 [cited 15 Oct 2021]. https:\/\/www.who.int\/data\/gho\/indicator-metadata-registry\/imr-details\/2380."},{"key":"pone.0262604.ref028","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/1742-4755-12-7","article-title":"A case\u2013control observational study of insulin resistance and metabolic syndrome among the four phenotypes of polycystic ovary syndrome based on Rotterdam criteria","volume":"12","author":"AS Jamil","year":"2015","journal-title":"Reproductive Health"},{"key":"pone.0262604.ref029","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1530\/EJE-14-0337","article-title":"Prevalence of insulin resistance and risk of diabetes mellitus in HIV-infected patients receiving current antiretroviral drugs","volume":"171","author":"S Araujo","year":"2014","journal-title":"Eur J Endocrinol"},{"key":"pone.0262604.ref030","doi-asserted-by":"crossref","DOI":"10.1001\/archpediatrics.2009.268","article-title":"Fasting Plasma Glucose Levels Within the Normoglycemic Range in Childhood as a Predictor of Prediabetes and Type 2 Diabetes in Adulthood: The Bogalusa Heart Study","volume":"164","author":"QM Nguyen","year":"2010","journal-title":"Arch Pediatr Adolesc Med"},{"key":"pone.0262604.ref031","volume-title":"Assessing Insulin Sensitivity and Resistance in Humans","author":"R Muniyappa","year":"2000"},{"key":"pone.0262604.ref032","doi-asserted-by":"crossref","first-page":"e0187670","DOI":"10.1371\/journal.pone.0187670","article-title":"Increasing prevalence of diabetes mellitus in a developing country and its related factors","volume":"12","author":"W Animaw","year":"2017","journal-title":"PLoS ONE"},{"key":"pone.0262604.ref033","doi-asserted-by":"crossref","first-page":"e011175","DOI":"10.1136\/bmjopen-2016-011175","article-title":"Diabetes mellitus among HIV-infected individuals in follow-up care at University of Gondar Hospital, Northwest Ethiopia","volume":"6","author":"SM Abebe","year":"2016","journal-title":"BMJ Open"},{"key":"pone.0262604.ref034","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1097\/QAI.0b013e318221863f","article-title":"Effect of Nonnucleoside Reverse Transcriptase Inhibitor\u2013Based Antiretroviral Therapy on Dysglycemia and Insulin Sensitivity in South African HIV-Infected Patients","volume":"57","author":"JA Dave","year":"2011","journal-title":"JAIDS Journal of Acquired Immune Deficiency Syndromes"},{"key":"pone.0262604.ref035","unstructured":"WHO. WHO | Diabetes country profiles Ethiopia. 2016 [cited 12 Apr 2021]. In: WHO [Internet]. https:\/\/www.who.int\/publications\/m\/item\/diabetes-eth-country-profile-ethiopia-2016."},{"key":"pone.0262604.ref036","unstructured":"IDF. IDF Africa Members Ethiopia. 2020 [cited 12 Apr 2021]. In: IDF [internet]. https:\/\/idf.org\/our-network\/regions-members\/africa\/members\/9-ethiopia.html."},{"key":"pone.0262604.ref037","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000002385","article-title":"Plasma Efavirenz Concentrations Are Associated With Lipid and Glucose Concentrations","volume":"95","author":"PZ Sinxadi","year":"2016","journal-title":"Medicine (Baltimore)"},{"key":"pone.0262604.ref038","doi-asserted-by":"crossref","DOI":"10.1186\/s40200-017-0310-x","article-title":"Risk factors for impaired fasting glucose or diabetes among HIV infected patients on ART in the Copperbelt Province of Zambia","volume":"16","author":"P Shankalala","year":"2017","journal-title":"J Diabetes Metab Disord"},{"key":"pone.0262604.ref039","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1080\/14740338.2019.1644317","article-title":"Metabolic complications affecting adipose tissue, lipid and glucose metabolism associated with HIV antiretroviral treatment","volume":"18","author":"C Lagathu","year":"2019","journal-title":"Expert Opinion on Drug Safety"},{"key":"pone.0262604.ref040","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000002844","article-title":"Risk Factors for Incident Diabetes in a Cohort Taking First-Line Nonnucleoside Reverse Transcriptase Inhibitor-Based Antiretroviral Therapy","volume":"95","author":"S Karamchand","year":"2016","journal-title":"Medicine"},{"key":"pone.0262604.ref041","doi-asserted-by":"crossref","first-page":"e0230723","DOI":"10.1371\/journal.pone.0230723","article-title":"Diabetes prevalence by HbA1c and oral glucose tolerance test among HIV-infected and uninfected Tanzanian adults","volume":"15","author":"K Jeremiah","year":"2020","journal-title":"PLOS ONE"},{"key":"pone.0262604.ref042","doi-asserted-by":"crossref","first-page":"e6916497","DOI":"10.1155\/2018\/6916497","article-title":"Prevalence, Risk Factors, and Pathophysiology of Dysglycemia among People Living with HIV in Sub-Saharan Africa","volume":"2018","author":"B Njuguna","year":"2018","journal-title":"Journal of Diabetes Research"},{"key":"pone.0262604.ref043","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1111\/tmi.12896","article-title":"New-onset type 2 diabetes mellitus among patients receiving HIV care at Newlands Clinic, Harare, Zimbabwe: retrospective cohort analysis","volume":"22","author":"C Chimbetete","year":"2017","journal-title":"Tropical Medicine & International Health"},{"key":"pone.0262604.ref044","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1086\/518619","article-title":"Factors Associated with the Incidence of Type 2 Diabetes Mellitus in HIV-Infected Participants in the Swiss HIV Cohort Study","volume":"45","author":"B Ledergerber","year":"2007","journal-title":"Clinical Infectious Diseases"},{"key":"pone.0262604.ref045","doi-asserted-by":"crossref","first-page":"671","DOI":"10.2471\/BLT.12.113415","article-title":"Differences by sex in the prevalence of diabetes mellitus, impaired fasting glycaemia and impaired glucose tolerance in sub-Saharan Africa: a systematic review and meta-analysis","volume":"91","author":"EH Hilawe","year":"2013","journal-title":"Bull World Health Organ"},{"key":"pone.0262604.ref046","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1210\/er.2015-1137","article-title":"Sex and Gender Differences in Risk, Pathophysiology and Complications of Type 2 Diabetes Mellitus","volume":"37","author":"A Kautzky-Willer","year":"2016","journal-title":"Endocr Rev"},{"key":"pone.0262604.ref047","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.phrs.2008.07.007","article-title":"Gender differences in the treatment of HIV infection","volume":"58","author":"M Floridia","year":"2008","journal-title":"Pharmacological Research"},{"key":"pone.0262604.ref048","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1038\/ijo.2014.163","article-title":"Visceral, subcutaneous abdominal adiposity and liver fat content distribution in normal glucose tolerance, impaired fasting glucose and\/or impaired glucose tolerance","volume":"39","author":"A-L Borel","year":"2015","journal-title":"International Journal of Obesity"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0262604","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,19]],"date-time":"2022-01-19T13:29:50Z","timestamp":1642598990000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0262604"}},"subtitle":[],"editor":[{"given":"Sonak D.","family":"Pastakia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,1,19]]},"references-count":48,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1,19]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0262604","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,19]]}}}