Antiretroviral therapy with or without protease inhibitors impairs postprandial TAG hydrolysis in HIV-infected men
Antiretroviral therapy with or without protease inhibitors impairs postprandial TAG hydrolysis in HIV-infected men
Mechanisms underlying the lipodystrophy syndrome associated with antiretroviral therapy (ART) for HIV infection are not completely understood. We investigated the effect of ART on blood lipid concentrations in the fasting state and after consumption of a meal containing [1-13C]palmitic acid in HIV-positive men receiving nucleoside reverse transcriptase inhibitors (NRTI, n 7), NRTI combined with protease inhibitors (PI; NRTIPI, n 6), in HIV-positive but therapy-naïve men (noART, n 5) and in HIV-seronegative men (controls, n 6). HIV-positive subjects had higher fasting TAG concentrations and resting energy expenditure than controls. Subjects receiving NRTIPI therapy had higher fasting NEFA concentrations than the other groups. There were no significant differences in postprandial lipid metabolism between noART subjects and controls. NRTI therapy impaired hydrolysis of meal-derived TAG, most evidently when combined with PI (the NRTIPI group). Accumulation of 13C-label in the NEFA fraction was not different between groups. In the NRTIPI group, fasting and postprandial NEFA concentrations were significantly higher than other groups. Postprandial glucose and insulin responses in HIV-positive subjects did not differ from controls. These findings suggest that ART dyslipidaemia is associated with impaired postprandial TAG clearance, which is exacerbated by NRTIPI therapy. If dyslipidaemia is to be minimised in ART, the specific adverse effects of particular combinations during the fed state should be considered.
hiv, protease inhibitors, nucleoside reverse transcriptase inhibitors, dyslipidaemia, stable isotopes
1038-1046
Ware, Lisa J.
74860e6c-ac74-44ae-bb62-a7a2032852ba
Jackson, Akil G.A.
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Wootton, Stephen A.
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Burdge, Graham C.
09d60a07-8ca1-4351-9bf1-de6ffcfb2159
Morlese, John F.
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Moyle, Graeme J.
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Jackson, Alan A.
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Gazzard, Brian G.
9511d3cb-fee6-4817-9f3a-f52b8405547b
October 2009
Ware, Lisa J.
74860e6c-ac74-44ae-bb62-a7a2032852ba
Jackson, Akil G.A.
a7a29c43-0d9c-4b99-90cc-b23c14a79424
Wootton, Stephen A.
bf47ef35-0b33-4edb-a2b0-ceda5c475c0c
Burdge, Graham C.
09d60a07-8ca1-4351-9bf1-de6ffcfb2159
Morlese, John F.
3b191039-a585-4c20-9fc9-a1adde790093
Moyle, Graeme J.
281f8799-6c3d-488c-9701-e0e649bd3f9e
Jackson, Alan A.
c9a12d7c-b4d6-4c92-820e-890a688379ef
Gazzard, Brian G.
9511d3cb-fee6-4817-9f3a-f52b8405547b
Ware, Lisa J., Jackson, Akil G.A., Wootton, Stephen A., Burdge, Graham C., Morlese, John F., Moyle, Graeme J., Jackson, Alan A. and Gazzard, Brian G.
(2009)
Antiretroviral therapy with or without protease inhibitors impairs postprandial TAG hydrolysis in HIV-infected men.
British Journal of Nutrition, 102 (7), .
(doi:10.1017/S0007114509338817).
(PMID:19480729)
Abstract
Mechanisms underlying the lipodystrophy syndrome associated with antiretroviral therapy (ART) for HIV infection are not completely understood. We investigated the effect of ART on blood lipid concentrations in the fasting state and after consumption of a meal containing [1-13C]palmitic acid in HIV-positive men receiving nucleoside reverse transcriptase inhibitors (NRTI, n 7), NRTI combined with protease inhibitors (PI; NRTIPI, n 6), in HIV-positive but therapy-naïve men (noART, n 5) and in HIV-seronegative men (controls, n 6). HIV-positive subjects had higher fasting TAG concentrations and resting energy expenditure than controls. Subjects receiving NRTIPI therapy had higher fasting NEFA concentrations than the other groups. There were no significant differences in postprandial lipid metabolism between noART subjects and controls. NRTI therapy impaired hydrolysis of meal-derived TAG, most evidently when combined with PI (the NRTIPI group). Accumulation of 13C-label in the NEFA fraction was not different between groups. In the NRTIPI group, fasting and postprandial NEFA concentrations were significantly higher than other groups. Postprandial glucose and insulin responses in HIV-positive subjects did not differ from controls. These findings suggest that ART dyslipidaemia is associated with impaired postprandial TAG clearance, which is exacerbated by NRTIPI therapy. If dyslipidaemia is to be minimised in ART, the specific adverse effects of particular combinations during the fed state should be considered.
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Published date: October 2009
Keywords:
hiv, protease inhibitors, nucleoside reverse transcriptase inhibitors, dyslipidaemia, stable isotopes
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Local EPrints ID: 69045
URI: http://eprints.soton.ac.uk/id/eprint/69045
ISSN: 0007-1145
PURE UUID: 0eb0047a-8c44-4e5f-8b90-ed2a946c973a
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Date deposited: 15 Oct 2009
Last modified: 13 Mar 2024 19:17
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Author:
Lisa J. Ware
Author:
Akil G.A. Jackson
Author:
John F. Morlese
Author:
Graeme J. Moyle
Author:
Brian G. Gazzard
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