Loading...
A major challenge in HIV care is how to manage visceral adiposity, a problem noted back in the early era of PI therapy, earning such names as “protease paunch” and “crix belly.” Despite these nicknames, however, visceral adiposity has no clear causal antiviral class or agent, like lipoatrophy does. One theory explored at this year’s International AIDS Conference was that some PIs trigger insulin resistance, which then influences adiposity. Graeme Moyle and colleagues evaluated the effects of switching from such PIs to ritonavir-boosted atazanavir, a PI known to have little effect on insulin sensitivity [Abstract MOPDB103]. Most (72%) of the 201 patients in the study were receiving lopinavir/ritonavir at baseline. Central fat accumulation wa…