Sir—The potency and sustained efficacy of highly active antiretroviral therapy (HAART)
including protease inhibitors have led to declining morbidity and mortality in patients with
advanced HIV infection. However, Keith Henry and colleagues (May 2, p 1328) 1 and
others2 have shown lipodystrophy and vascular complications during treatment with
protease inhibitors. We analysed lipid abnormalities in patients on protease inhibitors who
developed hypercholesterolaemia with symptomatic coronary or peripheral atherosclerosis …

Sir—Keith Henry and colleagues'1 report is important in the care of AIDS patients, since the
decline in mortality is linked to the introduction of protease inhibitor. We report four severe
vascular diseases in four HIV-infected patients (three on such drugs). Coronary angiography
showed a 90% left anterior descending coronary artery stenosis without thrombus in patient
1, a 90% stenosis of the left anterior descending coronary artery and a 70% stenosis of the
left circumflex and obtuse marginal artery in case 3, and a 90% stenosis of the right coronary …