9TH EUROPEAN AIDS CONFERENCE (EACS) 1st EACS RESISTANCE & PHARMACOLOGY WORKSHOP October 25 - 29, 2003 Warsaw, Poland

Objectives: To compare the respective role of HIV infection and anti-retroviral treatments on metabolic and morphologic parameters.

Methods: Monocentric prospective study in 60 naïve asymptomatic HIV patients followed over one year. The results were analysed according to the decision to treat (n=29), with or without PI (n=13 vs 16), or not to treat. Baseline results were compared to those of 52 healthy subjects individually matched for age, sex, smoking and BMI.

Results: At baseline, HIV patients differed from healthy subjects by a lower HDL cholesterol (c), higher fasting insulinemia and HOMA (p<0.05) while W/H ratio was similar. At baseline, before the decision to treat or not, HDLc was lower in PI treated patients (1.09±0.07 mM vs 1.41±0.08, p=0.01). After one year, in untreated patients, BMI and W/H ratio remained stable while HDLc decreased (1.41±0.08 mM vs 1.25±0.07, p=0.02). In the PI-treated patients, a significant increase in W/H ratio (p=0.03), in fasting blood glucose (+0.4±0.1 mM, p=0.045) and in LDLc (+0.9±0.3 mM p<0.05) was noted. Post glucose (75 g) glycemia, fasting and post glucose insulinemia, indices of insulin sensitivity and secretion did not change, nor in untreated, neither in PI or not-PI treated patients.

Conclusions: The decrease in HDLc in patients untreated during one year, as well as lower HDLc and higher insulin resistance in HIV patients compared to healthy subjects suggest a specific role of HIV. After a treatment of one year, we could not demonstrate a change in insulin secretion or sensitivity.

Presenting Author: Dr BENTATA Michelle, HOPITAL AVICENNE - AIDS UNIT, 125 Route de Stalingrad, 93009, BOBIGNY CEDEX, France, Phone: 00 33 1 48 95 51 44

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