Document Detail

Baseline lipid levels rather than the presence of reported body shape changes determine the degree of improvement in lipid levels after switching to atazanavir.
MedLine Citation:
PMID:  19632956     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To study factors influencing lipid changes after switching to atazanavir (ATV) and the effectiveness of ATV in maintaining virus suppression. METHODS: Retrospective cohort study in patients with viral suppression, comparing patients switching to ATV with those continuing combination antiretroviral therapy (cART). Outcome measures were 48-week total (TC), high-density (HDL) and low-density lipoprotein (LDL) cholesterol, and triglycerides (TG) changes, stratified for dyslipidemia and lipodystrophy and virological failure (time to first of two consecutive detectable HIV RNA). RESULTS: 225 patients switched to ATV (193 [85.8%] RTV boosted), and 3120 continued cART. In patients with baseline TC >6.2 mmol/L, those switching had greater mean (95% CI) TC decreases compared to those continuing cART (-1.26 [-1.63 to -0.89] and -0.54 [-0.64 to -0.44] mmol/L, p = .002). Likewise greater TG changes were observed in patients with high (>2.3 mmol/L) baseline TG (-1.44 [-2.05 to -0.83] and -0.54 [-0.70 to -0.38] mmol/L, p = .002). Effects were seen irrespective of presence of lipodystrophy. Patients switching to ATV had virological failure more often (17/224 [7.8%]) than those continuing cART (73/3100 [2.4%], p < .0001). CONCLUSIONS: Patients with virological suppression, including those with lipodystrophy, may benefit from switching to ATV with lipid profile improvement, especially if baseline lipid levels are high. This should be balanced against a possible higher virological failure risk.
M G A van Vonderen; L Gras; F Wit; K Brinkman; M E van der Ende; A I M Hoepelman; F de Wolf; P Reiss
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  HIV clinical trials     Volume:  10     ISSN:  1528-4336     ISO Abbreviation:  HIV Clin Trials     Publication Date:    2009 May-Jun
Date Detail:
Created Date:  2009-07-27     Completed Date:  2009-10-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100936377     Medline TA:  HIV Clin Trials     Country:  United States    
Other Details:
Languages:  eng     Pagination:  168-80     Citation Subset:  IM    
Department of Internal Medicine, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands.
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MeSH Terms
Anti-HIV Agents / therapeutic use*
Anti-Retroviral Agents / adverse effects
Body Mass Index
Body Size
Cohort Studies
Dyslipidemias / chemically induced,  prevention & control*
HIV Infections / drug therapy*,  virology*
Lipids / blood*
Middle Aged
Oligopeptides / therapeutic use*
Pyridines / therapeutic use*
Regression Analysis
Retrospective Studies
Viral Load
Reg. No./Substance:
0/Anti-HIV Agents; 0/Anti-Retroviral Agents; 0/Lipids; 0/Oligopeptides; 0/Pyridines; 198904-31-3/atazanavir

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