Abstract
HIV-infected patients who are naive to anti- retroviral therapy usually demonstrate decreased lipid levels as a consequence of infection. Treatment with antiretroviral agents may be gen- erally associated with a “return-to-baseline phenomenon” that should be considered when evaluating clinical trial findings. The older pro- tease inhibitors (PIs)—saquinavir, indinavir, riton- avir, nelfinavir, and amprenavir—have been associated with the development of hypertriglyc- eridemia, insulin resistance, and dyslipidemia. New PIs have been developed that have more favorable lipid profiles, offer more dosing options, and are associated with fewer short-term side effects. This article summarizes the compli- cations associated with the older and newer PIs and offers guidance for the clinical management of metabolic complications in patients taking anti- retroviral therapy.