INS and Insulin resistance: Exposure to certain PIs, including lopinavir/ritonavir, has also been associated with insulin resistance in vitro10,13 and in healthy volunteers.30,38 Despite the transcriptional changes observed suggesting insulin resistance in this study (Figure 1b), there was no effect on systemic insulin sensitivity (HOMA-IR), indicating that the transcriptional changes in SAT were insufficient to affect whole-body insulin sensitivity.