Lipid profiles for antiretroviral-naive patients starting PI- and NNRTI-based therapy in the Swiss HIV cohort study

Details

Serval ID
serval:BIB_2CA99B7FC263
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Lipid profiles for antiretroviral-naive patients starting PI- and NNRTI-based therapy in the Swiss HIV cohort study
Journal
Antiviral Therapy
Author(s)
Young  J., Weber  R., Rickenbach  M., Furrer  H., Bernasconi  E., Hirschel  B., Tarr  P. E., Vernazza  P., Battegay  M., Bucher  H. C.
ISSN
1359-6535 (Print)
Publication state
Published
Issued date
2005
Volume
10
Number
5
Pages
585-91
Notes
Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
Abstract
BACKGROUND: Blood lipid abnormalities in patients on highly active antiretroviral therapy (HAART) have been associated with exposure to protease inhibitors (PIs), particularly ritonavir. First therapy with a non-nucleoside reverse transcriptase inhibitor (NNRTI) leads to relatively favourable lipid profiles. We report on medium-term lipid profiles (up to 5 years) for antiretroviral-naive patients starting NNRTI- and PI-based HAART in the Swiss HIV Cohort Study. METHODS: Since April 2000, blood samples taken at visits scheduled every 6 months have been analysed for cholesterol and triglyceride concentrations. For 1065 antiretroviral-naive patients starting HAART after April 2000, we estimated changes in concentration over time using multivariate linear regression with adjustment for baseline covariates, use of lipid-lowering drugs and whether the sample was taken in a fasting state. RESULTS: Non-high density lipoprotein (HDL) cholesterol levels increase with increasing exposure to either PI- or NNRTI-based therapy, HDL cholesterol levels increase and triglyceride levels decrease with increasing exposure to NNRTI-based therapy, whereas triglyceride levels increase with increasing exposure to PI-based therapy. Between NNRTI-based therapies, there is a slight difference in triglyceride levels, which tend to increase with increasing exposure to efavirenz and to decrease with increasing exposure to nevirapine. Of the three common PI-based therapies, nelfinavir appears to have a relatively favourable lipid profile, with little change with increasing exposure. Of the other two PI therapies, lopinavir with ritonavir has a more favourable profile than indinavir with ritonavir, with smaller increases in both non-HDL cholesterol and triglycerides and an increase in HDL cholesterol. Increasing exposure to abacavir is associated with a decrease in the level of triglycerides. CONCLUSION: In general, NNRTI-based therapy is associated with a more favourable lipid profile than PI-based therapy, but different PI-based therapies are associated with very different lipid profiles. Nelfinavir appears to have a relatively favourable lipid profile. Of the two boosted PI therapies, lopinavir appears to have a more favourable lipid profile than indinavir.
Keywords
Antiretroviral Therapy, Highly Active Cohort Studies Drug Therapy, Combination Female HIV Infections/blood/*drug therapy HIV Protease Inhibitors/adverse effects/*therapeutic use Humans Hyperlipidemias/blood/etiology Lipids/*blood Male Prospective Studies Reverse Transcriptase Inhibitors/adverse effects/*therapeutic use Ritonavir/*pharmacology Switzerland Triglycerides/blood
Pubmed
Web of science
Create date
29/01/2008 8:52
Last modification date
20/08/2019 13:11
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