Document Detail


Effects of first-line use of nucleoside analogues, efavirenz, and ritonavir-boosted protease inhibitors on lipid levels.
MedLine Citation:
PMID:  19362991     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Andrew Hill; Will Sawyer; Brian Gazzard
Publication Detail:
Type:  Journal Article; Meta-Analysis    
Journal Detail:
Title:  HIV clinical trials     Volume:  10     ISSN:  1528-4336     ISO Abbreviation:  HIV Clin Trials     Publication Date:    2009 Jan-Feb
Date Detail:
Created Date:  2009-04-13     Completed Date:  2009-07-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100936377     Medline TA:  HIV Clin Trials     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1-12     Citation Subset:  IM    
Affiliation:
Pharmacology Research Laboratories, University of Liverpool, Liverpool, UK. microhaart@aol.com
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MeSH Terms
Descriptor/Qualifier:
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:
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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