For people with HIV (PWH) with low-to-moderate atherosclerotic cardiovascular disease (ASCVD) risk, metabolic risk factors contribute to new-onset diabetes mellitus (DM) among those treated with pitavastatin or placebo, according to a study published online Oct. 8 in the Annals of Internal Medicine.

Kathleen V. Fitch, from Massachusetts General Hospital and Harvard Medical School in Boston, and colleagues examined the contribution of known DM risk factors to excess risk for DM with pitavastatin use among PWH in the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) trial.

Participants included 7,731 PWH aged 40 to 75 years with a low-to-moderate risk for ASCVD, without DM at study entry, who were randomly assigned to pitavastatin 4 mg daily or placebo in a 1:1 ratio.

The researchers found that in each treatment group, participants with at least three DM risk factors versus no risk factors had an increased risk for DM (incidence rate, 3.24 versus 0.34 per 100 person-years in the pitavastatin group and 2.66 versus 0.27 per 100 person-years in the placebo group).

The highest incidence of DM was seen in South Asia. High body mass index, prediabetes, and metabolic syndrome components were strongly associated with new-onset DM in adjusted analyses.

“Together these data suggest the importance of implementing comprehensive risk reduction strategies for PWH with risk factors for DM, including dietary and exercise interventions,” the authors write.