| Changes in lipids and lipoprotein particle concentrations after interruption of antiretroviral therapy. | |
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MedLine Citation:
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PMID: 20658749 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The effect of interruption of antiretroviral therapy (ART) on lipoprotein particle subclasses has not been studied. We examined short-term changes in lipids and lipoprotein particles among 332 HIV-infected individuals randomized to interrupt or continue ART in the "Strategies for Management of Antiretroviral Therapy" trial. METHODS: Lipids and lipoprotein particles measured by nuclear magnetic resonance spectroscopy were compared between randomized groups at month 1; associations with inflammatory and coagulation markers (high sensitivity C-reactive protein; interleukin 6; amyloid A; amyloid P; D-dimer; prothrombin fragment 1 + 2) were assessed. RESULTS: Compared with continuation of ART, treatment interruption resulted in substantial declines in total, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol, and triglyceride, at month 1 but had little net effect on total/HDL cholesterol ratio [baseline-adjusted mean difference [95% confidence interval (CI)] interruption versus continuation arms: -0.10 (-0.59 to 0.38); P = 0.67]. ART interruption resulted in declines in total, large, and medium very low density lipoprotein (VLDL) particle concentrations (VLDL-p) and total and medium HDL-p. However, there was no change in small HDL-p [baseline-adjusted percentage difference between arms: -4.6% (-13.1%, +5.1% ); P = 0.35], small LDL-p [-5.0% (-16.9%, +8.6%); P = 0.45], or other LDL-p subclasses. Changes in lipid parameters on ART interruption did not differ according to baseline ART class (protease inhibitor versus non-nucleoside reverse transcriptase inhibitor) but were negatively associated both with changes in HIV viral load and with changes in inflammatory and coagulation markers, particularly D-dimer. CONCLUSIONS: These results suggest that ART interruption does not favorably influence overall lipid profile: there was little net effect on total/HDL cholesterol ratio, and no change in small LDL-p or small HDL-p, the lipoprotein particle subclasses most consistently linked to coronary risk. Short-term declines in lipid parameters after ART interruption were not associated with class of ART and may be linked to increases in viral replication, inflammation and coagulation. |
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Authors:
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Fiona C Lampe; Daniel A Duprez; Lewis H Kuller; Russell Tracy; James Otvos; Erik Stroes; David A Cooper; Jennifer Hoy; Nick I Paton; Nina Friis-Møller; Jacquie Neuhaus; Angelike P Liappis; Andrew N Phillips; |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Journal of acquired immune deficiency syndromes (1999) Volume: 54 ISSN: 1944-7884 ISO Abbreviation: J. Acquir. Immune Defic. Syndr. Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-07-22 Completed Date: 2010-07-26 Revised Date: 2011-09-06 |
Medline Journal Info:
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Nlm Unique ID: 100892005 Medline TA: J Acquir Immune Defic Syndr Country: United States |
Other Details:
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Languages: eng Pagination: 275-84 Citation Subset: IM; X |
Affiliation:
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Research Department of Infection and Population Health, University College London, London, United Kingdom. f.lampe@pcps.ucl.ac.uk |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00027352 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anti-HIV Agents / administration & dosage* Biological Markers / blood Drug Administration Schedule Female HIV Infections / blood*, drug therapy*, ethnology Humans Lipids / blood* Lipoproteins / blood* Male Middle Aged Time Factors |
| Grant Support | |
ID/Acronym/Agency:
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U01 AI046362-05/AI/NIAID NIH HHS; U01AI042170/AI/NIAID NIH HHS; U01AI46362/AI/NIAID NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Anti-HIV Agents; 0/Biological Markers; 0/Lipids; 0/Lipoproteins |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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