Niacin in HIV-infected individuals with hyperlipidemia receiving potent antiretroviral therapy.
BACKGROUND
Extended release (ER)-niacin therapy, which has been associated with reduced glucose tolerance in human immunodeficiency virus (HIV)-seronegative individuals, has not been evaluated in the HIV-infected population.


METHODS
This open, prospective trial evaluated the safety and efficacy of ER-niacin therapy for antiretroviral therapy-associated dyslipidemia. Fourteen individuals received ER-niacin at maximum doses of 2000 mg per day for 14 weeks.


RESULTS
Significant reductions in serum levels of triglycerides (P=.02), total cholesterol (P=.005), and non-HDL cholesterol (P=.04) were seen after ER-niacin therapy. Seven of 11 subjects were glucose intolerant after ER-niacin therapy; for 3 of these subjects, this was a new finding. Beta-cell sensitivity to basal glucose levels increased significantly without concomitant increase in overall glucose disposition indices. The values for the homeostasis model of insulin resistance index increased significantly (P=.005).


CONCLUSIONS
ER-niacin's role in the treatment of antiretroviral therapy-associated dyslipidemia requires further evaluation, but the results of this pilot study indicate that it is safe and tolerated and provides a valuable treatment option.
Division of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine, Saint Louis, MO, USA.
Marisa T
MT
Gerber
Kristin E
KE
Mondy
Kevin E
KE
Yarasheski
Henning
H
Drechsler
Sherry
S
Claxton
John
J
Stoneman
Debra
D
DeMarco
William G
WG
Powderly
Pablo
P
Tebas
D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D002784:Cholesterol / Q000097:blood; D003692:Delayed-Action Preparations; D005951:Glucose Tolerance Test; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D006949:Hyperlipidemias / Q000139:chemically induced / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D009525:Niacin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D010865:Pilot Projects; D011446:Prospective Studies; D014280:Triglycerides / Q000097:blood
D003692:Delayed-Action Preparations; D000960:Hypolipidemic Agents; D014280:Triglycerides; D009525:Niacin; D002784:Cholesterol