Important note: Information in this article was accurate in August 2000. The state of the art may have changed since the publication date.
One of the challenges facing researchers trying to understand HIV lipodystrophy syndrome is separating the effects caused by drugs from those caused by HIV infection. Researchers in San Francisco recruited 10 healthy HIV-negative male subjects whose ages ranged between 30 and 65 years. All subjects received indinavir at a dose of 800 mg three times daily for four weeks. Subjects submitted to a variety of tests before and after they took indinavir.
The researchers found no significant changes in the distribution of body fat. In other words, no decrease in subcutaneous fat or increase in abdominal fat was observed. As well, no significant changes were observed in the levels of cholesterol and triglycerides in the blood. The researchers did, however, find that subjects were becoming less sensitive to the effect(s) of insulin, a condition known as insulin resistance. Indeed, these subjects experienced an increase in their blood sugar levels - a consequence of insulin resistance - once they began to take indinavir.
The results from this short-term study suggest that indinavir reduces the ability of the body to respond to insulin. If left unchecked, insulin resistance can grow worse and lead to diabetes.
Researchers in Montreal have also conducted lab experiments on cells with protease inhibitors to try and understand the impact of these drugs on the sensitivity of cells to insulin. The researchers found that protease inhibitors affect the ability of insulin to interact with fat cells, which could cause fat cells to have difficulty removing sugar from the blood supply.
1. Noor M, Lo J, Mulligan K, et al. Metabolic effects of indinavir in healthy HIV-seronegative subjects. Abstract 010
2. Germinario RJ, Colby-Germinario SP, Cammalleri C and Wainberg M. The effects of a variety of protease inhibitors on insulin binding, insulin-mediated sugar transport and cell toxicity in insulin target and non-target cell cultures. Abstract 09.
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