INSTI Use Linked With Higher Risk of Incident DM Compared With Non-INSTI Regimens

Background: Integrase strand transfer inhibitors (INSTIs) are part of first-line antiretroviral therapy (ART) regimens for persons living with HIV (PLWHs). INSTIs have been associated with weight gain and incident diabetes mellitus (DM), and higher body mass index (BMI) is also associated with an increased risk of DM. The relationship between INSTIs, BMI gains, and DM risk, relative to ART regimens that do not contain INSTIs, however, remains unclear. Objective: To compare INSTI- versus non–INSTI-based ART regimens in terms of the association between BMI and the risk of new-onset DM. Design: Prospective, multicolor collaboration across Europe and Australia with >30,000 PLWHs, with data derived from the RESPOND consortium. Participants: Patients aged ≥18 years, on ART, with >1 BMI measurement. Methods: Patients were followed up from January 2012 to December 2019 or first event of DM (whichever came first). Those with a preexisting diagnosis of DM were excluded. Poisson regressio more...