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Safety of aerosol pentamidine prophylaxis for PCP on the endocrine pancreatic function in HIV-patients.


Int Conf AIDS. 1993 Jun 6-11;9(1):377 (abstract no. PO-B10-1452). Unique

Pancreatic side effects have been described with Pentamidine curative treatment for pneumocystis carinii pneumonia (PCP). We assessed the pancreatic beta-cells functions of HIV-patients receiving either 300 mg/month aerosolized Pentamidine (n = 12) or oral trimethoprime-sulfamethoxazole (TMP:160 mg, SM:800 mg twice a day three times/week, n = 10). All fully informed patients were in CDC stage III or IV. Intra-veinous glucose tolerance tests were performed: after IV injection of 0.5 g/kg BW glucose in 30 seconds, plasma insulin levels were assessed at baseline, 3 and 5 mn. Moreover, in patients receiving inhaled Pentamidine, plasma glucose, amylase and insulin levels were measured every 30 mn for 2 hours after the beginning of the aerosol therapy. Plasma Pentamidine levels were measured 30 mn after the end of the aerosol treatment. Those tests were performed every 2-3 months for one year. In all patients, pentamidine levels were detectable, but under toxic levels (50 ng/ml). Pentamidine plasma levels increased in a time-dependant manner: 1.8 ng/ml at 3 month, 2.5 at 6 month, 4.7 at 9 month, 5.7 at 12 month, 8.1 at 18 month, 8.4 after 18 months. Baseline plasma glucose, amylase and insulin levels were normal, and remain stable during the treatment. For 8/12 patients, glucose tolerance tests showed a adequate insulin secretion: the addition of insulin levels at 3 and 5 mn were higher than 70 IU/ml. When this criteria was not found (n = 4), a glucagon stimulation test allowed to exclude a endocrine pancreatic dysfunction. Because of a short half-life, increased pentamidine levels are probably related to an improvement of spray techniques rather than a cumulative effect. Pancreatic functions were preserved in pentamidine-treated patients compared to TMP-SM-treated patients. In conclusion, in this 12 month study, our results suggest the absence of side effects in preventive nebulised pentamidine treatment on endocrine pancreatic function.

*AIDS-Related Opportunistic Infections/PREVENTION & CONTROL *Insulin/BLOOD *Islets of Langerhans/DRUG EFFECTS *Pentamidine/ADVERSE EFFECTS *Pneumonia, Pneumocystis carinii/PREVENTION & CONTROL


Information in this article was accurate in November 30, 1993. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.