In:
European Journal of Endocrinology, Oxford University Press (OUP), Vol. 156, No. 4 ( 2007-04), p. 503-509
Abstract:
Objective : To evaluate the 24-week effects on glucose tolerance of switching from a protease inhibitor (PI)-based to an unboosted atazanavir-including regimen in highly pretreated HIV-1 infected subjects with metabolic alterations. Design : Prospective, open-label, single-center, 24-week pilot study. Methods : Twenty-one subjects underwent an oral glucose tolerance test (OGTT) at baseline (BL) and after 24 weeks of unboosted atazanavir. Insulin sensitivity and β-cell responsiveness were evaluated on the basis of static and dynamic data; fasting glucose, insulin, C-peptide, triglycerides (TG), total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-c), low-density lipoprotein-cholesterol (LDL-c), TC/HDL-c ratio, CD4+ cell count and HIV-1 RNA were measured. Results : After 24 weeks of unboosted atazanavir, the 120-min glucose level was significantly lower than the one measured at BL ( P =0.021); there were no statistically significant differences in the insulin concentration profile. The SI oral , an OGTT-based index of insulin sensitivity, was significantly higher at week 24 ( P =0.017); the indices of first- and second-phase β-cell responsiveness did not significantly change. There was no significant difference between BL and 24-week fasting glucose, insulin or C-peptide levels, and consequently no change in fasting homeostasis model assessment indices of insulin sensitivity and β-cell function. There were significant improvements in TG ( P =0.009), TC ( P =0.0001), LDL-c ( P =0.019) and TC/HDL-c ratio ( P =0.001), and a similar trend in HDL-c levels ( P =0.069). No significant changes in the immunological and virological parameters were detected. Conclusions : Our results show that switching from a PI-based to an unboosted atazanavir-including regimen leads to a significant improvement in glucose tolerance in highly pretreated HIV-1 infected subjects with metabolic alterations.
Type of Medium:
Online Resource
ISSN:
0804-4643
,
1479-683X
Language:
Unknown
Publisher:
Oxford University Press (OUP)
Publication Date:
2007
detail.hit.zdb_id:
1485160-X
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