AEGiS-05CROI: "Protease-paunch" in HIV+ persons receiving protease inhibitor therapy: incidence, risks and endocrinologic evaluation.

5th Conference on Retroviruses and Opportunistic Infections


Chicago, IL - February 1-5, 1998



"Protease-paunch" in HIV+ persons receiving protease inhibitor therapy: incidence, risks and endocrinologic evaluation.

Conf Retroviruses Opportunistic Infect 1998 Feb 1-5; 5th:156 (abstract no. 408)

Rosenberg HE, Mulder J, Sepkowitz KA, Giordano MF; Cornell University Medical College, NY.

Background: Long-term side effects of protease inhibitor (PI) therapy are emerging and include endocrinopathies such as diabetes mellitus. Endocrinologic investigation also has been undertaken in pts receiving PI who develop mid-section accumulation of fatty tissue without weight gain.

METHODS: All HIV+ patients receiving primary care from one MD (MFG) were evaluated for presence of "protease paunch." (PP). Additional data regarding risks for PP development and endocrinologic evaluation were extracted from patient charts. PP was defined as the body habitus of an HIV+ pt with increased abdominal girth and stable weight, unrelated to ascites or neoplasm, in the setting of PI therapy.

RESULTS: Of 120 patients (median age 38, 90% male) receiving care, 72 were on PI, of whom 5 (7%) developed PP. Characteristics of these 5 included: median age 46, 3/5 men, median CD4 195, VL 9132 copies. PP was noted a median of 18 m into PI therapy. One woman was post-menopausal, the other had regular menses. Further endocrinologic study revealed normal random cortisol, low-normal growth hormone (less than 1.5), normal somatomedin-C, normal serum glucose in 4/5. TFT's revealed subclinical hypothyroidism in one (TSH of 5.3). In one woman, FSH, LH, testosterone, DHEA sulfate, androstenedione, and prolactin were normal.

CONCLUSION: PP in our study occurred in older pts receiving long-term PI therapy. Although PP may resemble Cushing's Syndrome, evaluation of adrenal, thyroid, and gonadal axes has been unrevealing. More sensitive measures of endocrinologic function, including objective measures of body composition (bioelectrical impedance (BIA) and dual-energy X-ray absorptiometry (DEXA)) may be useful. In addition, the association between PP and risk for progression of HIV needs to be determined.

Keywords: AEGIS, HIV Protease Inhibitors, Evaluation Studies, Incidence, Risk, Body Composition, Endopeptidases, Risk Factors, Electric Impedance, Adipose Tissue, Body Weight, Human, Female, Male, therapy, nursing, epidemiology, AIDSKWDaegis,hivproteaseinhibitors,evaluationstudies,incidence,risk,bodycomposition,endopeptidases,riskfactors,electricimpedance,adiposetissue,bodyweight,human,female,male,therapy,nursing,epidemiology,aids

1998-02-01
408

Copyright © 1998 - Foundation for Retrovirology and Human Health (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the Foundation for Retrovirology and Human Health. Licensed from National Library of Medicine.