Alterations in Serum Levels of Lipids and Lipoproteins with Indinavir Therapy for Human Immunodeficiency Virus‐Infected Patients

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Abstract
Alterations in lipid metabolism have been associated with the use of protease inhibitors. Sequential lipid analyses were performed on serum samples from human immunodeficiency virus-infected antiretroviral-naive patients who received indinavir in combination with two nucleoside reverse transcriptase inhibitors. Serum levels of cholesterol, triglycerides, high-density lipoproteins (HDLs), and low-density lipoproteins (LDLs) were measured at baseline and at periodic intervals. After 48 weeks of indinavir therapy, mean serum levels 6 SD rose as follows: cholesterol, from 167.2 ± 36.0 to 206.3 ±32.4 mg/dL (P < .0005); triglycerides, from 110.4 ± 47.5 to 158.4 ± 72.5 mg/dL (P < .0101); and LDLs, from 106.6 ± 35.1 to 136.1 ± 31.6 mg/dL (P = .0029). There was no significant change in the serum HDL fraction. Mean serum lipoprotein (a) levels ± SD rose from 6.5 ± 1.4 to 9.6 ± 2.0 mg/dL after 30 weeks (P = .0695). Potential mechanisms for the noted increases include alterations in serum lipoprotein lipase activity or changes in hepatic lipid metabolism. The clinical significance of these changes remains to be determined.

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