Atherogenic dyslipidemia in HIV-infected individuals treated with protease inhibitors. The Swiss HIV Cohort Study.

Details

Serval ID
serval:BIB_AB60BAAC8483
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Atherogenic dyslipidemia in HIV-infected individuals treated with protease inhibitors. The Swiss HIV Cohort Study.
Journal
Circulation
Author(s)
Périard D., Telenti A., Sudre P., Cheseaux J.J., Halfon P., Reymond M.J., Marcovina S.M., Glauser M.P., Nicod P., Darioli R., Mooser V.
ISSN
1524-4539[electronic]
Publication state
Published
Issued date
1999
Volume
100
Number
7
Pages
700-5
Language
english
Notes
Publication types: Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't - Publication Status: ppublish
Abstract
BACKGROUND: Administration of protease inhibitors (PIs) to HIV-infected individuals has been associated with hyperlipidemia. In this study, we characterized the lipoprotein profile in subjects receiving ritonavir, indinavir, or nelfinavir, alone or in combination with saquinavir. METHODS AND RESULTS: Plasma lipoprotein levels were quantified in 93 HIV-infected adults receiving PIs. Comparison was done with pretreatment values and with 28 nonPI-treated HIV-infected subjects. An elevation in plasma cholesterol levels was observed in all PI-treated groups but was more pronounced for ritonavir (2.0+/-0.3 mmol/L [mean+/-SEM], n=46, versus 0.1+/-0.2 mmol/L in nonPI treated group, P<0.001) than for indinavir (0.8+/-0.2 mmol/L, n=26, P=0.03) or nelfinavir (1.2+/-0.2 mmol/L, n=21, P=0.01). Administration of ritonavir, but not indinavir or nelfinavir, was associated with a marked elevation in plasma triglyceride levels (1.83+/-0.46 mmol/L, P=0.002). Plasma HDL-cholesterol levels remained unchanged. Combination of ritonavir or nelfinavir with saquinavir did not further elevate plasma lipid levels. A 48% increase in plasma levels of lipoprotein(a) was detected in PI-treated subjects with pretreatment Lp(a) values >20 mg/dL. Similar changes in plasma lipid levels were observed in 6 children receiving ritonavir. CONCLUSIONS: Administration of PIs to HIV-infected individuals is associated with a marked, compound-specific dyslipidemia. The risk of pancreatitis and premature atherosclerosis due to PI-associated dyslipidemia remains to be established.
Keywords
Adult, Anti-HIV Agents, Arteriosclerosis, Child, Drug Therapy, Combination, Female, HIV Infections, HIV Protease Inhibitors, Humans, Hypercholesterolemia, Hyperlipidemias, Hypertriglyceridemia, Indinavir, Lipids, Lipoprotein(a), Lipoproteins, Logistic Models, Male, Nelfinavir, Risk Factors, Ritonavir, Saquinavir, Thyrotropin
Pubmed
Web of science
Create date
28/01/2008 12:45
Last modification date
20/08/2019 16:15
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