| Effects of first-line use of nucleoside analogues, efavirenz, and ritonavir-boosted protease inhibitors on lipid levels. | |
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MedLine Citation:
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PMID: 19362991 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Treatment with ritonavir-boosted protease inhibitors or efavirenz and nucleoside analogues leads to rises in lipids, which might contribute to cardiovascular risk. METHOD: A MEDLINE search for clinical trials of first-line HAART with standardized 48-week lipids data available for combinations of two nucleoside analogues identified 13 with additional boosted protease inhibitor (PI/r) regimens (n = 5,281) and two with efavirenz (n = 1,087). Inverse-variance weighting was used to provide estimates of combined 48-week elevations in each lipid parameter. RESULTS: The trials were well balanced for mean baseline total cholesterol (155 mg/dL), triglycerides (125 mg/dL), LDL (95 mg/dL), and HDL (37 mg/dL). The PIs showed two different types of lipid elevations: Group 1: saquinavir/r, atazanavir/r, and darunavir/r; and Group 2: lopinavir/ritonavir and fosamprenavir/r. There were greater elevations in total cholesterol and triglycerides for Group 2 compared to Group 1 but no differences in LDL or HDL between Group 1 and Group 2. Patients treated with efavirenz showed similar rises in total cholesterol and LDL compared with the PIs in Group 2 but showed smaller rises than in Group 1. In addition, patients treated with abacavir/lamivudine, zidovudine/lamiuvudine, or stavudine/lamivudine showed significantly higher elevations in all four lipid parameters, compared with patients given tenofovir/emtricitabine. CONCLUSION: There is a wide range of lipid elevations during 48 weeks of first-line HAART, which depends on the choice of antiretrovirals used. |
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Authors:
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Andrew Hill; Will Sawyer; Brian Gazzard |
Publication Detail:
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Type: Journal Article; Meta-Analysis |
Journal Detail:
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Title: HIV clinical trials Volume: 10 ISSN: 1528-4336 ISO Abbreviation: HIV Clin Trials Publication Date: 2009 Jan-Feb |
Date Detail:
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Created Date: 2009-04-13 Completed Date: 2009-07-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100936377 Medline TA: HIV Clin Trials Country: United States |
Other Details:
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Languages: eng Pagination: 1-12 Citation Subset: IM |
Affiliation:
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Pharmacology Research Laboratories, University of Liverpool, Liverpool, UK. microhaart@aol.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Antiretroviral Therapy, Highly Active Benzoxazines / therapeutic use* Cholesterol / blood* Cholesterol, HDL / blood Cholesterol, LDL / blood Clinical Trials as Topic HIV Infections / drug therapy* HIV Protease Inhibitors / blood*, therapeutic use* Humans Nucleosides / therapeutic use* Reverse Transcriptase Inhibitors / therapeutic use* Ritonavir / therapeutic use* Triglycerides / blood |
| Chemical | |
Reg. No./Substance:
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0/Benzoxazines; 0/Cholesterol, HDL; 0/Cholesterol, LDL; 0/HIV Protease Inhibitors; 0/Nucleosides; 0/Reverse Transcriptase Inhibitors; 0/Ritonavir; 0/Triglycerides; 154635-17-3/efavirenz; 57-88-5/Cholesterol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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