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[The HIV protease inhibitor-induced insulin resistance syndrome]
Morten Schütt1, Markus Meier, Harald H Klein
1Medizinische Klinik I, Universitätsklinikum Schleswig-Holstein, Campus Lübeck. morten.schuett@web.de
Background:
HIV protease inhibitors improve the morbidity and mortality of HIV infection, however, this therapy also initiates insulin resistance that is associated with an increasing development of disturbances in glucose and lipid metabolism. Similar to the common insulin resistance syndrome, treated patients also suffer from an increased cardiovascular risk.
Pathogenesis:
Studies based on animal or cell models suggest that HIV protease inhibitors induce short-term effects on GLUT4 glucose transport and longterm effects on insulin signal transduction.
Conclusion:
Therapy with HIV protease inhibitors should include regular monitoring of metabolic alterations and cardiovascular damage. Particularly patients with genetic or traditional risk factors for type 2 diabetes should be monitored frequently.