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Effects on insulin sensitivity and hepatic safety of Atazanavir in HCV/HIV coinfected patients versus HIV monoinfected: A prostective 48-week study
https://doi.org/10.1186/1742-4690-7-S1-P63
© Meijide et al; licensee BioMed Central Ltd. 2010
- Published: 11 May 2010
Keywords
- Atazanavir
- AIDS Clinical Trial Group
- Glucose Transporter GLUT4
- Include Body Mass Index
- Immunological Failure
Background
Protease inhibitors based antiretroviral therapy has been associated with elevated plasma insulin levels and insulin resistance. HCV infections are an independent risk factor for diabetes development. In vitro Atazanavir (ATV) has shown minimal inhibitory effect on the insulin-regulated glucose transporter GLUT4. Studies in healthy HIV-negative demonstrated a favorable metabolic profile. Clinical studies in HIV and HCV/HIV coinfected pretreated patients with underlying real conditions are needed.
Methods
51 pretreated HIV-1 infected patients who started ATV/r were included prospectively. Insulin resistance was assessed by HOMA (Homeostasis Model Assesment). Hepatotoxicity was defined according to AIDS Clinical Trials Group criteria to ALT values. Clinical data and laboratory parameters were analyzed at baseline and every 12 weeks up to 48. It includes body mass index (BMI), fasting glucose, insulin, triglycerides (TG), total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-c), CD4+ cell count and HIV-1 RNA. HIV monoinfected and HIV/HCV co-infected (pos HCV-RNA) patients were compared.
Results
Table 1
HCV | BASAL | 48-WEEK | Δw48-w0 | P(Δw48-w0) | |
|---|---|---|---|---|---|
BMI (Kg/m2) | - | 24.5 (22-27) | 26 (23-29) | 0.34 (-1.0-+0.9) | >.05 |
+ | 22 (20-26) | 20 (18-23) | -0.35 (-0.8-+1.2) | >.05 | |
Fasting glucose (mg/dl) | - | 87 (83-97) | 88 (85-95) | -0.5 (-5.7-+8) | >.05 |
+ | 94 (83-103) | 90 (80-105) | +2 (-24-+12) | >.05 | |
HOMA | - | 1 (0.8-3.6) | 1.4 (0.9-3.2) | -0.06 (-1.5-+0.8) | >.05 |
+ | 3.5 (1.8-6.3) | 4.5 (3-7.5) | +1.8 (-4.6-+3.1) | >.05 | |
TC (mg/dl) | - | 197 (165-215) | 179 (161-200) | -18 (-40- -3) | .02 |
+ | 157 (132-174) | 144 (127-165) | -5 (-32-+15) | >.05 | |
TG (mg/dl) | - | 149 (122-241) | 126 (101-208) | -10 (-92-+17) | >.05 |
+ | 139 (99-186) | 114 (89-197) | 0 (-19-+59) | >.05 |
Discussion
ATV/r can be safely used in patients with chronic viral hepatitis. ATV/r regimens do not induce insulin resistence and has a good lipid profile in coinfected as in monoinfected patients. These results would be better with unboosted ATV regimens.
Authors’ Affiliations
Copyright
This article is published under license to BioMed Central Ltd.
