Of the therapeutic agents used to treat HIV infection, protease inhibitors in particular have been epidemiologically linked to dyslipidemia and insulin resistance.1198 1200 The protease inhibitors amprenavir/fosam- prenavir with or without ritonavir and lopinavir with ritonavir have the strongest association with risk of AMI, although saquinavir and nelfinavir do not appear to be associated with MI.1201,1202 The nucleoside reverse-transcriptase inhibitors didanosine and abacavir also are associated with risk of AMI.1202 Other agents, such as nonnucleoside reverse- transcriptase inhibitors (nevirapine and efavirenz), entry in- hibitors, and integrase inhibitors, do not appear to be associ- ated with an increased risk of IHD. Despite the increase in prevalence of IHD among patients with HIV, the absolute increase in incidence of AMI is relatively low, and overall mortality does not appear to be increased.1198,1203 It is likely that this reflects the otherwise enormous benefit conferred by treatment with highly active antiretroviral therapy in the course of HIV infection. None- theless, patients receiving highly active antiretroviral therapy should be assessed for cardiovascular risk factors and moni- tored for signs and symptoms of IHD. It is prudent to recommend a healthy diet, regular physical activity, and avoidance of smoking. Patients with hypercholesterolemia should be managed in a fashion similar to other patients at risk for IHD.1204 5.12.7. Autoimmune Disorders Connective tissue disease represents a less well-studied issue in SIHD. 