Boosting dose ritonavir does not alter peripheral insulin sensitivity in healthy HIV-seronegative volunteers

Steven A. Taylor, Grace A. Lee, Vivian Y. Pao, Jayaranjan Anthonypillai, Francesca T. Aweeka, Jean Marc Schwarz, Kathleen Mulligan, Morris Schambelan, Carl Grunfeld

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)361-364
Number of pages4
JournalJournal of Acquired Immune Deficiency Syndromes
Volume55
Issue number3
DOIs
StatePublished - Nov 1 2010

Keywords

  • HIV protease inhibitors
  • glucose
  • insulin resistance
  • lopinavir
  • ritonavir

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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    Taylor, S. A., Lee, G. A., Pao, V. Y., Anthonypillai, J., Aweeka, F. T., Schwarz, J. M., Mulligan, K., Schambelan, M., & Grunfeld, C. (2010). Boosting dose ritonavir does not alter peripheral insulin sensitivity in healthy HIV-seronegative volunteers. Journal of Acquired Immune Deficiency Syndromes, 55(3), 361-364. https://doi.org/10.1097/QAI.0b013e3181e6a7d9