Metabolic and anthropometric consequences of interruption of highly active antiretroviral therapy

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Abstract
HAART has been associated with metabolic abnormalities (hyperlipidemia, insulin resistance, alterations in cortisol metabolism) and fat redistribution. A prospective study of 26 Caucasian men (median age 43.5 years) with HIV-1 viral loads Serum lipids, glucose and insulin levels during an oral glucose tolerance test, 24-h urinary free cortisol and 17-hydroxycorticosteroids, and anthropometric parameters were measured before HAART cessation and prior to its reinstitution. When baseline values were compared with those obtained after HAART interruption (means ± SD), there was a significant decrease in total cholesterol (194 ± 47.3 versus 159 ± 29.3 mg/dl;P P A relatively brief interruption of HAART resulted in significant improvements in total cholesterol, LDL cholesterol, and triglyceride levels. No changes were observed in insulin resistance profiles or anthropometric measurements, perhaps because of the brief duration of HAART interruption. These results suggest that hyperlipidemia and alterations in corticosteroid metabolism in the setting of HAART are a direct drug effect that reverses with drug withdrawal. However, glucose metabolism and fat redistribution do not change over the short term.