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[Lipodystrophy and hyperglycemia produced by protease inhibitors]
1Unidad de Enfermedades Infecciosas, Hospital General Universitario de Alicante.
Lipodystrophy (LD) can occur in patients taking any HIV-1 protease inhibitor (PI). This body fat redistribution syndrome is often self-limiting, with many patients able to continue PI treatment.
Area of Science:
- Endocrinology
- Virology
- Metabolic Disorders
Context:
- HIV-1 protease inhibitors (PI) are crucial for antiretroviral therapy.
- A subset of patients on PIs develop lipodystrophy (LD), characterized by abnormal fat distribution.
- The underlying mechanisms and clinical implications of PI-associated LD require further elucidation.
Purpose:
- To determine the prevalence and clinical presentation of lipodystrophy in patients using HIV-1 protease inhibitors.
- To investigate associated metabolic derangements, specifically glucose metabolism.
- To describe the follow-up and management of patients with PI-induced lipodystrophy.
Summary:
- A study of 272 patients revealed a 1.8% prevalence of lipodystrophy associated with all available protease inhibitors.
- The most common pattern involved fat accumulation in the abdomen and breasts, with loss in extremities and face.
- While basal glucose was normal, oral glucose tolerance tests indicated carbohydrate intolerance in two patients, particularly those with a family history of type 2 diabetes.
Impact:
- This research highlights that lipodystrophy is a potential side effect of various protease inhibitors.
- The findings suggest that PI-associated lipodystrophy is often manageable and may not necessitate treatment cessation.
- Understanding the prevalence and clinical course of LD aids in optimizing HIV treatment strategies and patient care.
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