HIV Infections Clinical Trial
Official title:
AACTG Modified Frequently Sampled Intravenous Glucose Tolerance Test (FSIVGTT) for the Assessment of Insulin Sensitivity: A Substudy of A5079
The purpose of this study is to find out if testosterone gel affects how the body handles
insulin and glucose.
Specific anti-HIV treatments may increase a patient's risk of certain diseases by causing
metabolic problems such as reduced sensitivity to insulin. This substudy will examine how
testosterone affects insulin sensitivity. If testosterone increases insulin sensitivity in
the patients, then giving testosterone to HIV-infected patients may allow the continuation
of anti-HIV treatments without increasing the patients' risk of disease. The test used to
determine insulin sensitivity will be a modified frequently sampled intravenous glucose
tolerance test (FSIVGTT), which can accurately measure insulin sensitivity.
Assessment of insulin sensitivity is an important objective of this substudy. Extrapolation
from earlier studies suggests that insulin resistance will be associated with low
testosterone levels at baseline in HIV-infected men with visceral obesity and that
physiologic testosterone replacement in these individuals is likely to increase insulin
sensitivity. However, direct assessment of insulin sensitivity under carefully controlled
conditions is crucial to understanding the full metabolic impact of physiologic testosterone
replacement in the context of A5079. The FSIVGTT, using the Bergman minimal model, has
become a widely used method for the assessment of insulin sensitivity in epidemiological and
intervention studies. Based on these considerations, the modified FSIVGTT was chosen as the
optimal modality to assess insulin sensitivity in A5112s.
This study is a substudy of A5079. Patients enrolled in A5079 are eligible for this substudy
but receive no study treatment other than that which they receive on A5079. Insulin
sensitivity is measured by FSIVGTT performed at entry and at Weeks 24 and 48. In the
modified FSIVGTT, 15 serial blood specimens for glucose are drawn over a 245-minute
interval. The FSIVGTT assesses whether patients given testosterone supplements have more
sensitivity to insulin than patients given a placebo.
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