Longitudinal analysis of the associations between antiretroviral therapy, viraemia and immunosuppression with lipid levels: the D:A:D study.

Détails

ID Serval
serval:BIB_BB464CF5CA08
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Longitudinal analysis of the associations between antiretroviral therapy, viraemia and immunosuppression with lipid levels: the D:A:D study.
Périodique
Antiviral therapy
Auteur⸱e⸱s
Kamara D.A., Smith C., Ryom L., Reiss P., Rickenbach M., Phillips A., Mocroft A., De Wit S., Law M., Monforte A.D., Dabis F., Pradier C., Lundgren J.D., Sabin C.
ISSN
2040-2058 (Electronic)
ISSN-L
1359-6535
Statut éditorial
Publié
Date de publication
2016
Peer-reviewed
Oui
Volume
21
Numéro
6
Pages
495-506
Langue
anglais
Notes
Publication types: Journal Article ; Observational Study
Publication Status: ppublish
Résumé
Antiretroviral (ART) drugs have been associated with higher triglycerides (TG), higher total cholesterol (TC) and lower high-density lipoprotein cholesterol (HDL-C) levels. Associations between lipid levels with HIV viraemia and immunosuppression in the presence of ART remain unclear.
Participants from the D:A:D study with at least one TG/TC/HDL-C measurement were included. Linear mixed effect models were used to determine the association of ART, viral load (VL), nadir and current CD4+ T-cell count and previous AIDS diagnosis with lipids.
Of 49,717 participants, 90%, 92% and 80% contributed at least one TG/TC/HDL-C measurement (median follow-up 6.8, 6.8 and 5.0 years, respectively). Predicted mean (95% CI) baseline levels for TG, TC and HDL-C (mmol/l), were 2.10 (2.05, 2.14), 4.94 (4.91, 4.98) and 1.08 (1.07, 1.10), respectively. Lopinavir was associated with the worst TG profile, (27.2% higher levels compared to atazanavir; 95% CI 25.2%, 29.2%), and darunavir had a similar profile as atazanavir. The nucleoside pair lamivudine/tenofovir was associated with the most favourable TG profile (-2.8%; -3.5%, -2.0%) compared with emtricitabine/tenofovir, whereas lamivudine/abacavir (+10.2%; +9.3%, +11.2%) and lamivudine/stavudine (+8.0%; +6.9%, +9.0%), were associated with the worst. Raltegravir was associated with lower TG (-5.2%; -6.4%, -3.9%), and nevirapine had a more favourable HDL-C profile (+11.3%; +10.8%, +11.7%) than efavirenz (+5.3%; 5.0%, 5.7%), compared to atazanavir. Higher VLs were associated with lower TG/TC/HDL-C, whereas higher CD4+ T-cell counts were associated with higher TG/TC/HDL-C.
TG, TC and HDL-C levels, which generally improved over time, are dependent on ART, viraemia and, to a lesser extent, immunosuppression.

Mots-clé
Adult, Anti-HIV Agents/therapeutic use, CD4 Lymphocyte Count, Cholesterol/blood, Cholesterol, HDL/blood, Cohort Studies, Female, HIV Infections/blood, HIV Infections/drug therapy, HIV Infections/virology, Humans, Immune Tolerance, Linear Models, Lipids/blood, Longitudinal Studies, Male, Prospective Studies, Time Factors, Triglycerides/blood, Viral Load, Viremia/blood, Viremia/drug therapy, Viremia/virology
Pubmed
Web of science
Création de la notice
03/04/2017 18:00
Dernière modification de la notice
20/08/2019 15:29
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