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Adverse metabolic effects of boosted protease inhibitors include abnormalities of glucose metabolism, such as insulin resistance, impaired glucose tolerance, and frank diabetes mellitus. Although high-dose ritonavir (≥800 mg daily) has been shown to affect insulin secretion, little is known about the metabolic toxicity of boosting-dose ritonavir (100–200 mg daily).
In this randomized, double-blind, crossover study, 10 healthy HIV-negative volunteers received a single 200-mg dose of ritonavir or placebo. Insulin-mediated glucose disposal (an accepted surrogate for insulin sensitivity) was then measured using a euglycemic hyperinsulinemic clamp. Ritonavir was found to have no effect on this outcome.