Effects of protease inhibitors on glucose tolerance, lipid metabolism, and body composition in children and adolescents infected with human immunodeficiency virus.
OBJECTIVE
To evaluate the effects of protease inhibitors (PIs) as antiretroviral therapy in comparison with other antiretroviral (non-PI) medications on glucose tolerance, lipid metabolism, and body fat distribution in human immunodeficiency virus (HIV)-infected young patients.


METHODS
We conducted a cross-sectional clinical study in an outpatient HIV clinic. The study population consisted of 21 patients (15 female and 6 male) who had had at least 6 months of antiretroviral treatment. The mean age of the patients was 11.9 years (range, 6 to 16.5).


RESULTS
Fifteen patients treated with PIs and 6 patients treated with non-PIs were enrolled in the study. We found no significant differences in the lipid panel and insulin resistance, as determined by using the Quantitative Insulin Sensitivity Check Index formula, in the PI group in comparison with the non-PI group. Lipodystrophy was observed in 47% (7 of 15) of the PI group and 33% (2 of 6) of the non-PI group (P = 0.66). In the presence of lipodystrophy, serum triglyceride levels were higher in the PI group than in the non-PI group (P = 0.046). No such difference was found between the treatment groups when no lipodystrophy was present. There was no significant difference in insulin resistance between the treatment groups in the presence or absence of lipodystrophy.


CONCLUSIONS
Our study found the presence of lipodystrophy in HIV-infected young patients regardless of whether they were taking PIs or not. In the patients who had lipodystrophy, those treated with PIs had higher serum triglyceride levels than those not treated with PIs.
Ergun-Longmire
Berrin
B
Division of Pediatric Endocrinology, New York-Presbyterian Hospital, Weill Medical College of Cornell University, New York, NY 10021, USA.
Lin-Su
Karen
K
Dunn
Ann M
AM
Chan
Lily
L
Ham
Kirsis
K
Sison
Cristina
C
Stavola
Joseph
J
Vogiatzi
Maria G
MG
D000293:Adolescent; D044966:Anti-Retroviral Agents / Q000494:pharmacology / Q000627:therapeutic use; D019540:Area Under Curve; D001786:Blood Glucose / Q000032:analysis / Q000187:drug effects*; D001823:Body Composition / Q000187:drug effects*; D015992:Body Mass Index; D002648:Child; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005951:Glucose Tolerance Test; D015658:HIV Infections / Q000097:blood* / Q000188:drug therapy; D006801:Humans; D007333:Insulin Resistance; D050356:Lipid Metabolism / Q000187:drug effects*; D008060:Lipodystrophy / Q000097:blood / Q000188:drug therapy; D008297:Male; D011480:Protease Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D014280:Triglycerides / Q000097:blood; D049629:Waist-Hip Ratio
D044966:Anti-Retroviral Agents; D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D011480:Protease Inhibitors; D014280:Triglycerides; D002784:Cholesterol