The Metabolic Effects of Protease Inhibitors in HIV Infected Children
Status:
Completed
Trial end date:
1969-12-31
Target enrollment:
Participant gender:
Summary
The use of protease inhibitors is increasing in HIV-infected children because this treatment
has resulted in improved body weight, improved immune status and less hospitalizations.
However, recent reports suggest that these drugs may also be associated with some negative
side-effects, specifically a syndrome of diabetes and fat redistribution. Development of the
fat redistribution/diabetes syndrome has recently been reported in HIV-infected children, as
well as in adults. Diabetes is associated with complications such as increased heart disease,
eye disease and loss of kidney function. Thus development of diabetes is a significant
problem which could outweigh the benefits obtained by treating patients with protease
inhibitors. One major cause of diabetes is lack of normal response to insulin (insulin
resistance). Insulin resistance tends to be worse in family members where one or more parent
has diabetes, and is also worse in certain ethnic groups. The first major purpose of our
study is measure insulin resistance in HIV-infected children who do not take protease
inhibitors, and compare our findings to those from patients who are treated with protease
inhibitors. We will also follow patients newly treated with protease inhibitors for two years
to evaluate changes in insulin sensitivity. These results will be correlated with each
patient's family history of diabetes and with ethnicity, and should help us better predict
which children are "at risk" for development of diabetes from protease inhibitor therapy.
Children with HIV infection often have problems with gaining enough weight and with poor
linear growth (height). One likely reason for this is the way their bodies use and store
protein. The second purpose of our study is measure protein turnover and to correlate our
findings with growth data. We also plan to study the effects of protease inhibitor therapy on
protein turnover. We believe that these studies will provide knowledge to help clinicians
formulate recommendations for nutritional and medical therapy.