Insulin Sensitivity and β-Cell Function in Protease Inhibitor-Treated and -Naive Human Immunodeficiency Virus-Infected Children

Previous pediatric studies have failed to demonstrate a clear association between protease inhibitor (PI) therapy and abnormal glucose homeostasis in HIV-infected children. To define more precisely the impact of PI therapy on glucose homeostasis in this population, we performed the insulin-modified frequent-sampling iv glucose tolerance test on 33 PI-treated and 15 PI-naive HIV-infected children. Other investigations included fasting serum lipids; glucose, insulin, and C-peptide; single-slice abdominal computed tomography; and, in a subset of PI-treated children, an oral glucose tolerance test. There were no differences between the two groups with respect to fasting serum insulin or C-peptide, homeostatic model assessment insulin resistance, or quantitative insulin sensitivity check index. The mean insulin sensitivity index of PI-treated and PI-naive children was 6.93 ± 6.37 and 10.58 ± 12.93 × 10−4min−1 [μU/ml]−1, respectively (P = 0.17). The mean disposition index for the two groups was 1840 ± 1575 and ...