Postprandial response to a physiologic caloric load in HIV-positive patients receiving protease inhibitor-based or nonnucleoside reverse transcriptase inhibitor-based antiretroviral therapy

Asha Thomas-Geevarghese, Subhashree Raghavan, Robert Minolfo, Steve Holleran, Rajasekhar Ramakrishnan, Bernard Ormsby, Wahida Karmally, Henry N. Ginsberg, Wafaa M. El-Sadr, Jeanine Albu, Lars Berglund

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Background: Features of the dyslipidemic pattern reported with the use of antiretroviral therapy predict enhanced postprandial lipemia, which is an emerging cardiovascular disease risk factor. Objective: We evaluated the postprandial response to a physiologic, meal-based challenge in HIV-positive subjects without hyperlipidemia. Design: We measured hourly lipid, lipoprotein, glucose, and insulin concentrations during a 13-h period in 25 non white patients (13 women, 12 men): 13 receiving a protease inhibitor (PI)-based regimen (6 nelfinavir and 7 indinavir) and 12 receiving a nonnucleoside reverse transcriptase inhibitor (NNRTI)-based regimen (6 efavirenz and 6 nevirapine). Results: Mean fasting HDL-cholesterol concentrations were lower in HIV patients than in healthy subjects without HIV infection matched for age, sex, and ethnicity (z score: -0.81 ± 0.9; P = 0.0001). Fasting triacylglycerol concentrations were not significantly different between HIV-infected patients and healthy subjects but were higher in Pi-treated than in NNRTI-treated patients [median (interquartile range): 144 (110-191) and 89 (62-135) mg/dL; P = 0.007]. Average daylong triacylglycerol concentrations, but not incremental concentrations, were higher in the PI group than in the NNRTI group [205% (185-248%) and 125% (78-191%); P < 0.05]. For all HIV-positive patients, the fractional triacylglycerol increase was lower after breakfast than after lunch (20 ± 18% and 42 ± 40%, respectively; P < 0.04). Insulin concentrations were higher in PI-treated than in NNRTI-treated patients [22.6 (13.1-29.8) and 11.8 (7.1-19.1) μU/mL; P = 0.01] and increased in both groups in response to each meal, whereas glucose concentrations increased only after breakfast. Conclusions: Despite baseline differences, incremental triacylglycerol and insulin responses to a physiologic caloric load among HIV-positive patients were not significantly affected by differences in the type of antiretroviral therapy.

Original languageEnglish (US)
Pages (from-to)146-154
Number of pages9
JournalAmerican Journal of Clinical Nutrition
Volume82
Issue number1
StatePublished - 2005

Keywords

  • African Americans
  • Antiretroviral treatment
  • ART
  • HIV
  • Insulin resistance
  • NNRTI
  • Nonnucleoside reverse transcriptase inhibitor
  • Postprandial lipemia
  • Protease inhibitors

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Food Science

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    Thomas-Geevarghese, A., Raghavan, S., Minolfo, R., Holleran, S., Ramakrishnan, R., Ormsby, B., Karmally, W., Ginsberg, H. N., El-Sadr, W. M., Albu, J., & Berglund, L. (2005). Postprandial response to a physiologic caloric load in HIV-positive patients receiving protease inhibitor-based or nonnucleoside reverse transcriptase inhibitor-based antiretroviral therapy. American Journal of Clinical Nutrition, 82(1), 146-154.