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Unexplained thrombosis in HIV-infected patients receiving protease inhibitors: report of seven cases

1999; Elsevier BV; Volume: 107; Issue: 6 Linguagem: Inglês

10.1016/s0002-9343(99)00296-x

1555-7162

Sarah L. George, Susan Swindells, Ralph Knudson, Jack T. Stapleton,

HIV Research and Treatment

Although HIV (human immunodeficiency virus) and AIDS (acquired immune deficiency syndrome)-associated morbidity and mortality have been reduced substantially by the addition of HIV protease inhibitor therapy ( 1 Powderly W.G. Landay A. Lederman M.M. Recovery of the immune system with antiretroviral therapy the end of opportunism?. JAMA. 1998; 280: 72-77 Crossref PubMed Scopus (215) Google Scholar ), reports have surfaced describing unanticipated complications of treatment, including insulin resistance, diabetes, lipodystrophy, pseudo-Cushings syndrome, and bleeding diasthesis in patients with hemophilia ( 2 Hemophilia Information Exchange. HIV Protease Inhibitors and Patients with Hemophilia. Medical Bulletin #250, Chapter Advisory #252. National Hemophilia Foundation, New York City, New York, July 17, 1996. Google Scholar , 3 CDC report on bleeding complications observed among persons with hemophilia treated with protease inhibitors. United States Public Health Service Centers for Disease Control, Atlanta, Georgia, January 1997. Google Scholar , 4 Carr A. Samaras K. Burton S. et al. A syndrome of peripheral lipodystrophy (LD), hyperlipidemia and insulin resistance in patients receiving HIV protease inhibitors. AIDS. 1998; 12: F51-F58 Crossref PubMed Scopus (2203) Google Scholar , 5 Henry K. Melroe H. Huebesch J. et al. Atorvastatin and gemfibrozil for protease-inhibitor-related lipid abnormalities. Lancet. 1998; 352: 1031-1032 Abstract Full Text Full Text PDF PubMed Scopus (216) Google Scholar ). There have also been case reports of premature coronary artery disease and peripheral vascular disease associated with protease inhibitor use ( 6 Henry K. Melroe H. Huebsch J. et al. Severe premature coronary artery disease with protease inhibitors. Lancet. 1998; 351: 1328 Abstract Full Text Full Text PDF PubMed Scopus (486) Google Scholar , 7 Behrens G, Schmidt H, Meyer D, et al. Vascular complications associated with use of HIV protease inhibitors. Lancet 1998;351:1958. Letter. Google Scholar , 8 Gallet B, Pulik M, Genet P, et al. Vascular complications associated with use of HIV protease inhibitors. Lancet 1998;351:1958–1959. Letter. Google Scholar ) and ascribed to protease inhibitor-induced hypercholesterolemia.