
February 2003 From Journal of Clinical Investigation HAART and heart disease The use of combinations of antiretroviral drugs including nucleoside analogs, protease inhibitors (PIs) and reverse transcriptase inhibitors - collectively termed highly active anti-retroviral therapy (HAART) - has resulted in a dramatic improvement in health status for a large number of HIV-infected individuals.Side effects in many users, however, cause non-adherence to treatment regimes and concern over their long-term use in the management of chronic HIV infection. The adverse effects of PIs include abnormalities in lipid metabolism, insulin resistance, and premature atherosclerosis. Whether the latter is caused directly by the drugs or as a consequence of lipid abnormalities and insulin resistance has not been clear- until now. A report in the February 3 issue of the Journal of Clinical Investigation shows that HIV protease inhibitors directly promote atherosclerosis in mice. Led by Eric Smart, the researchers from the University of Kentucky Medical School in Lexington also examined the situation in human cells, and found that protease inhibitors induced changes in particular cells (called macrophages) that are like those seen in atherosclerotic lesions. In an accompanying Commentary article, David Hui, a heart disease specialist at the University of Cincinnati College of Medicine, discusses the implications of these findings. He proposes a mechanism by which these drugs might promote heart disease, and suggests ways to disrupt it. CONTACT: Eric Smart University of Kentucky Department of Physiology 423 Sanders-Brown 800 South Limestone Lexington, KY 40536 USA PHONE: 859-323-6412 FAX: 859-323-1070 E-mail: [email protected] View the PDF of this article at: https://www.the-jci.org/press/16261.pdf ACCOMPANYING COMMENTARY: HIV Protease Inhibitors and Atherosclerosis CONTACT: David Y. Hui University Of Cincinnati College Of Medicine Department Of Pathology and Laboratory Medicine 231 Albert Sabin Way Mail Stop 529 Cincinnati, OH 45267-0529 USA Phone 1: 513-558-9152 Fax 1: 513-558-2141 E-mail: [email protected] View the PDF of this commentary at: https://www.the-jci.org/press/17746.pdf |