Prospective, intensive study of metabolic changes associated with 48 weeks of amprenavir-based antiretroviral therapy.
To determine whether a 48-week course of amprenavir-based antiretroviral therapy is associated with metabolic alterations, 14 clinically stable human immunodeficiency virus (HIV)-infected, protease inhibitor-naive adults initiated amprenavir-based triple therapy. Twelve subjects (86%) achieved HIV RNA levels of <400 copies/mL at week 24. Fasting glucose and insulin levels did not change. Insulin sensitivity did not decrease in the first 24 weeks, but a trend toward a decrease appeared at week 48. Six subjects experienced onset or worsening of glucose tolerance by week 24. Levels of fasting triglycerides and low-density lipoprotein, high-density lipoprotein, and total cholesterol increased. Bone mineral content, lean tissue, total fat, trunk fat, limb fat, and the ratio of trunk to limb fat increased at week 48. Amprenavir-based therapy was associated with increases in serum lipid levels but no short-term decrease in insulin sensitivity. A trend toward insulin resistance appeared late in the study following weight gain, particularly of trunk fat, but without loss of limb fat.
Dubé
Michael P
MP
Department of Medicine, Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, IN, USA. mpdube@iupui.edu
Qian
Dajun
D
Edmondson-Melançon
Hannah
H
Sattler
Fred R
FR
Goodwin
Diane
D
Martinez
Carmen
C
Williams
Vanessa
V
Johnson
Debra
D
Buchanan
Thomas A
TA
D000328:Adult; D019380:Anti-HIV Agents / Q000494:pharmacology* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D001823:Body Composition / Q000187:drug effects*; D002219:Carbamates; D004334:Drug Administration Schedule; D005260:Female; D005663:Furans; D005947:Glucose / Q000378:metabolism; D015658:HIV Infections / Q000188:drug therapy / Q000378:metabolism*; D006801:Humans; D050356:Lipid Metabolism; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D013449:Sulfonamides / Q000494:pharmacology* / Q000627:therapeutic use
D019380:Anti-HIV Agents; D002219:Carbamates; D005663:Furans; D013449:Sulfonamides; C095108:amprenavir; D005947:Glucose