[Lipodystrophy and hyperglycemia produced by protease inhibitors].
BACKGROUND
HIV-1 protease inhibitors (PI) have been recently associated with a syndrome of anomalous body fat distribution or lipodystrophy (LD), which sometimes is associated to hyperglycemia. Many aspects of this syndrome remain obscure. The objective of the study is to describe the prevalence, clinical patterns, derangement of glucose metabolism associated and follow-up.


METHODS
Patients taking at least one PI during January 1998 were asked a questionnaire about any body change, and a physical exam looking for fat changes was performed. In patients found to have LD, basal plasma glucose, cholesterol, triglycerides and cortisol were studied, and an oral glucose tolerance test (OGTT) was performed. In those cases with breast enlargement, prolactin and estradiol were measured.


RESULTS
Among 272 patients, five cases (1.8%) of LD were detected. The syndrome appeared associated with all the IP available at the time of the study, a medium of 4.2 months after the introduction of the drug. The most common pattern was fat accumulation in abdomen and breast, and fat loss in arms, legs and face. Basal glycemia was normal in all 5 patients, but OGTT showed carbohydrate intolerance in two (both of them had family antecedents of type 2 diabetes mellitus). Only one patient need treatment withdrawal because of progressive deforming changes.


CONCLUSIONS
The LD can appear in patients taking any IP. Body changes are usually self limited and in many patients PI don't need to be stopped.
Reus
S
S
Unidad de Enfermedades Infecciosas, Hospital General Universitario de Alicante.
Arroyo
E
E
Boix
V
V
Portilla
J
J
D000328:Adult; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000188:drug therapy; D017320:HIV Protease Inhibitors / Q000009:adverse effects*; D015497:HIV-1; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D008060:Lipodystrophy / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013577:Syndrome
D017320:HIV Protease Inhibitors