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Scientific article
English

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

Contributors

Young, Jim; Weber, Rainer; Rickenbach, Martin; Furrer, Hansjakob; Bernasconi, Enos; Hirschel, Bernard; Tarr, P. E.; Vernazza, Pietro; Battegay, Manuel; Bucher, H. C.

Published in

Antiviral therapy, vol. 10, no. 5, p. 585-591

Publication date

2005

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

UNIGE affiliation entities

Citation (ISO format)

YOUNG, Jim et al. Lipid profiles for antiretroviral-naive patients starting PI- and NNRTI-based therapy in the Swiss HIV cohort study. In: Antiviral therapy, 2005, vol. 10, n° 5, p. 585–591.

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Additional URL for this publication

http://www.intmedpress.com/journals/avt/abstract.cfm?id=703&pid=88

Journal ISSN

1359-6535
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Technical informations

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21/06/2010 10:27:16

First validation

21/06/2010 10:27:16

Update

14/03/2023 15:46:21

Status update

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