This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Background. Extended release (ER) niacin therapy, which has been associated with reduced glucose tolerance in human immunodeficiency virus (HIV) seronegative individuals, has not been evaluated in the HIV-infected population. Methods. This open, prospective trial evaluated the safety and efficacy of ER-niacin therapy for antiretroviral therapy associated dyslipidemia. Fourteen individuals received ER-niacin at maximum doses of 2000 mg per day for 14 weeks. Results. Significant reductions in serum levels of triglycerides (P = .02), total cholesterol (P = .005), and non-HDL cholesterol (P = .04) were seen after ER-niacin therapy. Seven of 11 subjects were glucose intolerant after ER-niacin therapy; for 3 of these subjects, this was a new finding. beta-cell sensitivity to basal glucose levels increased significantly without concomitant increase in overall glucose disposition indices. The values for the homeostasis model of insulin resistance index increased significantly (P = .005). Conclusion. ER-niacin's role in the treatment of antiretroviral therapy-associated dyslipidemia requires further evaluation, but the results of this pilot study indicate that it is safe and tolerated and provides a valuable treatment option.
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