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J Acquir Immune Defic Syndr. 2010 Nov;55(3):361-4. doi: 10.1097/QAI.0b013e3181e6a7d9.

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

Author information

1
Department of Medicine, University of California, San Francisco, CA, USA.

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.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00525239.

PMID:
20595906
PMCID:
PMC3164483
DOI:
10.1097/QAI.0b013e3181e6a7d9
[Indexed for MEDLINE]
Free PMC Article
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