Anti retroviral (ARV) is used to treat patients with HIV-infected. But, some HIV-1 resistances from ARV have been reported. Besides all these reports, guideline of treatment has been established by WHO to control HIV. There are many studies to search the most effective combination of the drugs to inhibit HIV. Then, I read a journal that ARV (especially Protease Inhibitor/PI) impacts the risk of Myocardial Infarction (MI) in HIV-infected patients (Lang, 2010).
Based on this study, “the risk of Myocardial Infection was increased by cumulative exposure to all the studied PIs except saquinavir and particularly to amprenavir/fosamprenavir with or without ritonavir and lopinavir with ritonavir, whereas the association with abacavir cannot be considered causal (Lang, 2010).”
The other study said that PI had so many metabolic effects, peripheral fat wasting and excessive central fat deposition (lipodystrophy), overt hyperlipidemia, and insulin resistance. The HIV protease inhibitors also suppress proteasome-mediated breakdown of nascent apolipoprotein (apo) B, thus resulting in the overproduction and secretion of triglyceride-rich lipoproteins. Finally, protease inhibitor also suppresses the inhibition of the glucose transporter GLUT-4 activity in adipose and muscle. This latter effect also contributes directly to insulin resistance and diabetes (Hui, 2003).
All of these adverse effect make patients with PI regiment easily get Myocardial Infarction. Maybe PI is effective to control HIV, but we must consider about the adverse effect.
References:
Lang, Sylvie. et al. 2010. Impact of Individual Antiretroviral Drugs on the Risk of Myocardial Infarction in Human Immunodeficiency Virus–Infected Patients. ARCH INTERN MED/VOL 167 (NO. 16), SEP 10, 2007
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