Buzibye, A, Castelnuovo, B, Bollinger, RC, Ssebulime, J, Omali, D, Muller, D, Mulindwa, F, Laker, E, Waitt, C 
ORCID: 0000-0003-0134-5855, Andia, I et al (show 4 more authors)
(2025)
Dolutegravir-associated hyperglycemia: a narrative review
AIDS Research and Therapy, 22 (1).
93-.
ISSN 1742-6405, 1742-6405
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Text
Dolutegravir-associated hyperglycemia a narrative review.pdf - Open Access published version Available under License Creative Commons Attribution Non-commercial No Derivatives. Download (1MB) | Preview |
Abstract
Dolutegravir is a preferred antiretroviral drug given its high resistance barrier and efficacy; however, reports from sub-Saharan Africa indicate increased hyperglycemia rates among individuals living with HIV on dolutegravir. Potential mechanisms include mitochondrial dysfunction from previous exposure to NRTIs like stavudine and zidovudine, which causes mitochondrial toxicity and predisposes patients to hyperglycemia upon switching to dolutegravir; magnesium chelation, which is borrowed from dolutegravir’s mode of action (dolutegravir inhibits the action of integrase by chelation of magnesium required as a cofactor by the HIV enzyme); and chronic inflammation, with elevated pro-inflammatory markers like IL-6, CRP, and TNF-α contributing to insulin resistance. The narrative review highlights variability in hyperglycemia among patients, influenced by genetics, lifestyle, and prior antiretroviral therapy. The exact nature of dolutegravir-associated hyperglycemia, whether due to insulin resistance or reduced insulin release, remains unclear, although insulin resistance is significant.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Dolutegravir, Hyperglycemia, Type-2 diabetes, Africa, HIV |
| Divisions: | Faculty of Health & Life Sciences Faculty of Health & Life Sciences > Inst. Life Courses & Medical Sciences Faculty of Health & Life Sciences > Inst. Life Courses & Medical Sciences > Inst. Life Courses & Medical Sciences (T&R staff) Faculty of Health & Life Sciences > Inst. Life Courses & Medical Sciences > Women's & Children's Health |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 14 Oct 2025 07:14 |
| Last Modified: | 28 Feb 2026 20:40 |
| DOI: | 10.1186/s12981-025-00800-1 |
| Related Websites: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3194827 |
| Disclaimer: | The University of Liverpool is not responsible for content contained on other websites from links within repository metadata. Please contact us if you notice anything that appears incorrect or inappropriate. |
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