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Many of the early protease inhibitors (PIs) were associated with the development of metabolic syndrome, but the newer ritonavir-boosted PIs seem relatively free of this side effect. In a small, randomized, open-label trial, researchers compared metabolic changes associated with two of the newest boosted PIs, darunavir and atazanavir. The study involved 65 treatment-naive HIV-infected adults and was sponsored by the maker of darunavir.
Twelve weeks into treatment, fasting triglyceride levels rose slightly in both groups (by a mean of 22 mg/dL in the darunavir group and 8 mg/dL in the atazanavir group.) Total cholesterol levels also rose, slightly more in the darunavir group than in the atazanavir group. Apolipoprotein A1 levels rose in the da…