Medical Pharmacology Chapter 36: Antiviral Drugs
Antiviral Drugs
Anti-viral drugs with activity against HIV (Human Immunodeficiency Virus)
HIV-1 Pathophysiology/Pathogenesis: HIV Disease Presentations
Drug-Induced Myocardial Disease (continued)
HIV Protease Inhibitors (continued)
Protease inhibitor administration for management of HIV-1 infection has been associated with elevated risks for both hyperlipidemia and hyperglycemia.8
In a study involving 5672 outpatients with HIV infection between 1993 and 2002, the frequency of myocardial infarctions (heart attacks) increased following the 1996 introduction of protease inhibitors.8
The study reported that in 19 of the 3247 patients taking a protease inhibitor but it only 2 of the 2425 patients not taking a protease inhibitor was a myocardial infarction observed.
The authors concluded that there is an elevated risk of myocardial infarction in patients with HIV-1 related to protease inhibitor administration, although the risk may be small.8
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Another more recent study compared nonnucleoside reverse-transcriptase inhibitors and protease inhibitors with respect to possible elevation of myocardial infarction risk.
In this study administration of protease inhibitors was associated with increased myocardial infarction risk which was considered possibly partially accounted for by dyslipidemia.
However, no evidence of a comparable association was noted for the nonnucleoside reverse-transcriptase inhibitor class.
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