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Altered Glucose Metabolism in HIV-infected Patients Treated With HAART

6646 Crystal Downes Ct, Caledonia, MI 49316;leejc{at}trinity-health.org

The introduction of protease inhibitors (PIs) has revolutionized the treatment of human immunodeficiency virus (HIV)– positive patients. The consequences of potential long-term metabolic complications have led to the use of PI-sparing regimens. As HIV treatment with PIs is associated with lipodystrophy (fat redistribution, hyperlipidemia, and glucose intolerance), it is essential to effectively manage these long-term toxicities. The impact of PI-induced glucose intolerance has resulted in studies investigating both pathogenesis andmanagement of this side effect. The action of PIs on the glucose transporter, GLUT4, may explain themechanismof action of PI use on glucose tolerance. Insulin-sensitizing agents, such as metformin and thiazolidinediones, may improve glucose intolerance, insulin resistance, and lipodystrophy caused by PI therapy.

Key Words: HIV • protease inhibitors • glucose intolerance • metformin • thiazolidinediones.

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