Alterations in serum levels of lipids and lipoproteins with indinavir therapy for human immunodeficiency virus-infected patients

Alterations in lipid metabolism have been associated with the use of protea se inhibitors. Sequential lipid analyses were performed on serum samples fr om human immunodeficiency virus-infected antiretroviral-naive patients who received indinavir in combination with two nucleoside reverse transcriptase inhibitors, Serum levels of cholesterol, triglycerides, high-density lipop roteins (HDLs), and low-density lipoproteins (LDLs) were measured at baseli ne and at periodic intervals. After 48 weeks of indinavir therapy, mean ser um levels a SD rose as follows: cholesterol, from 167.2 +/- 36.0 to 206.3 /- 32.4 mg/dL (P < .0005); triglycerides, from 110.4 +/- 47.5 to 158.4 +/- 72.5 mg/dL (P < .0101); and LDLs, from 106.6 +/- 35.1 to 136.1 +/- 31.6 mg/ dL (P = .0029), There was no significant change in the serum HDL fraction. Mean serum lipoprotein (a) levels +/- SD rose from 6.5 +/- 1.4 to 9.6 +/- 2 .0 mg/dL after 30 weeks (P = .0695), Potential mechanisms for the noted inc reases include alterations in serum lipoprotein lipase activity or changes in hepatic lipid metabolism. The clinical significance of these changes rem ains to be determined.