Metabolic Effects of PIs vs. NNRTIs

Five-year results from the FIRST trial suggest that the choice between a PI and an NNRTI in initial therapy does not play an important role in limb-fat loss.

Chronic conditions such as diabetes, cardiovascular disease, and the metabolic syndrome may be more common in HIV-infected people than in the general population. Data support the concern that antiretroviral therapy, and possibly specific drug choices, may contribute to the premature onset of these diseases or increase their severity.

In a substudy of the FIRST (Flexible Initial Retrovirus Suppressive Therapies) trial, investigators assessed changes in metabolic parameters and body composition among 422 antiretroviral-naive patients randomized to start therapy with two NRTIs plus either a PI, an NNRTI, or a PI + NNRTI. The most commonly used PIs were nelfinavir (61%), ritonavir-boosted PIs (24%), and indinavir (12%). Nevirapine and efavirenz …

Reviewing Author

Graeme Moyle, MD

Metabolic Effects of PIs vs. NNRTIs

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Reviewing Author