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PI use has been linked to an increased risk for cardiovascular disease (AIDS Clin Care Apr 25 2007). Dyslipidemia is at least partially responsible, but other mechanisms are also being explored. In previous studies, indinavir has been shown to cause both endothelial dysfunction and a decrease in insulin sensitivity. Now, investigators have evaluated these same parameters for the newer PIs atazanavir and lopinavir/ritonavir. (One of the investigators has consulted for or received research support from the makers of both drugs.)
Thirty healthy, nonobese, HIV-negative men were randomized to receive atazanavir (400 mg daily), lopinavir/r (400/100 mg twice daily), or placebo for 4 weeks. At baseline and week 4, participants were assessed for endo…