TITLE:
Insulin Sensitivity of Term Newborns Exposed in Utero to HIV and Antiretrovirals in Yaoundé
AUTHORS:
Francine Mendane Ekobena, Audrey Christance Donfack, Hortence Fouedjio, Suzanne Ngo Um Sap, Martine Claude Etoa Etoga, Mesmin Dehayem, Anne Boli Ongmeb, Gabriel Loni Ekali, Jean Claude Mbanya, Eugène Sobngwi
KEYWORDS:
Insulin Sensitivity, Newborns, Antiretrovirals, HIV, C Peptide, HOMA-IR
JOURNAL NAME:
Open Journal of Endocrine and Metabolic Diseases,
Vol.13 No.9,
September
27,
2023
ABSTRACT: Introduction: Antiretrovirals (ARVs) and the human
immunodeficiency virus (HIV) are implicated in the onset of insulin resistance.
They cross the placental barrier thereby inducing early modifications of the
fetal environment. The aim of our study was to assess insulin sensitivity in
full-term newborns exposed in utero to HIV and ARVs in Yaoundé. Materials
and Methods: We conducted an analytical cross-sectional study in 2
maternities in the city of Yaoundé from November 2021 to June 2022. We
generated two groups of newborns (NBs): one
group born to HIV positive mothers on ARVs and the other control group born to HIV negative mothers. Clinical data from mothers and NBs
were collected. A homeostatic model assessment of insulin resistance (HOMA-IR)
like index with C peptide served to assess insulin sensitivity. We used the
Spearman correlation to measure the strength of
association between insulin sensitivity and the different variables. A p-value Results: Of
70 neonates included, 35 were born to HIV positive mothers on ARVs and 35 to HIV negative mothers. The median age of HIV positive and negative mothers was 30 (27 - 32) and 34 (24 - 47) years, respectively (p = 0.791). The body mass index before pregnancy
as well as the average newborn weights were comparable
in both groups. The ARV protocol associating Tenofovir, Lamivudine,
Efavirenz was used by 97.1% of HIV positive mothers. In the exposed NBs group, C peptide was significantly lower (p blood glucose significantly higher (p - 1.9) and 2 (1.4 - 2.6) (p = 0.001) for exposed and unexposed NBs, respectively. Conclusion: Newborns exposed to HIV and ARVs had lower C peptide
levels and were more sensitive to insulin. Close metabolic monitoring of these
newborns would allow early diagnosis and management of any glucose regulation
disorder.