TY - JOUR
T1 - Boosting dose ritonavir does not alter peripheral insulin sensitivity in healthy HIV-seronegative volunteers
AU - Taylor, Steven A.
AU - Lee, Grace A.
AU - Pao, Vivian Y.
AU - Anthonypillai, Jayaranjan
AU - Aweeka, Francesca T.
AU - Schwarz, Jean Marc
AU - Mulligan, Kathleen
AU - Schambelan, Morris
AU - Grunfeld, Carl
PY - 2010/11/1
Y1 - 2010/11/1
N2 - Background: Some HIV protease inhibitors (PIs), including full-dose ritonavir (800 mg) and ritonavir-boosted lopinavir, acutely induce insulin resistance in the absence of HIV infection and changes in body composition. Boosting dose ritonavir (100-200 mg) is the most commonly prescribed PI, yet its effects on glucose metabolism have not been described in the absence of another PI. Methods: In this randomized, double-blind, cross-over study, a single dose of ritonavir 200 mg or placebo was given to healthy HIV-seronegative volunteers before assessment of insulin sensitivity by euglycemic hyperinsulinemic clamp. Results: Boosting dose ritonavir had no effect on insulin-mediated glucose disposal (M/I, placebo: 8.59 ± 0.83 vs. ritonavir: 8.51 ± 0.64 mg/kg per minute per μU/mL insulin, P = 0.89). Conclusions: A single boosting dose of ritonavir does not alter insulin sensitivity, suggesting lopinavir is likely responsible for the induction of insulin resistance demonstrated in prior short-term studies of lopinavir/ritonavir. There is a dose-dependent effect of ritonavir on insulin sensitivity.
AB - Background: Some HIV protease inhibitors (PIs), including full-dose ritonavir (800 mg) and ritonavir-boosted lopinavir, acutely induce insulin resistance in the absence of HIV infection and changes in body composition. Boosting dose ritonavir (100-200 mg) is the most commonly prescribed PI, yet its effects on glucose metabolism have not been described in the absence of another PI. Methods: In this randomized, double-blind, cross-over study, a single dose of ritonavir 200 mg or placebo was given to healthy HIV-seronegative volunteers before assessment of insulin sensitivity by euglycemic hyperinsulinemic clamp. Results: Boosting dose ritonavir had no effect on insulin-mediated glucose disposal (M/I, placebo: 8.59 ± 0.83 vs. ritonavir: 8.51 ± 0.64 mg/kg per minute per μU/mL insulin, P = 0.89). Conclusions: A single boosting dose of ritonavir does not alter insulin sensitivity, suggesting lopinavir is likely responsible for the induction of insulin resistance demonstrated in prior short-term studies of lopinavir/ritonavir. There is a dose-dependent effect of ritonavir on insulin sensitivity.
KW - HIV protease inhibitors
KW - glucose
KW - insulin resistance
KW - lopinavir
KW - ritonavir
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UR - http://www.scopus.com/inward/citedby.url?scp=78049317637&partnerID=8YFLogxK
U2 - 10.1097/QAI.0b013e3181e6a7d9
DO - 10.1097/QAI.0b013e3181e6a7d9
M3 - Article
C2 - 20595906
AN - SCOPUS:78049317637
SN - 1525-4135
VL - 55
SP - 361
EP - 364
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
IS - 3
ER -