Document Detail


Switching the nucleoside reverse transcriptase inhibitor backbone to tenofovir disoproxil fumarate + emtricitabine promptly improves triglycerides and low-density lipoprotein cholesterol in dyslipidaemic patients.
MedLine Citation:
PMID:  20053692     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To assess the impact of switching to tenofovir disoproxil fumarate + emtricitabine on lipid parameters. METHODS: HIV-infected patients with plasma viral load <400 copies/mL, fasted triglycerides from 2.3 to 11.4 mmol/L and/or fasted low-density lipoprotein (LDL)-cholesterol >4.1 mmol/L were randomized to switch the nucleoside reverse transcriptase inhibitor (NRTI) backbone to fixed-dose combination tenofovir disoproxil fumarate + emtricitabine or to maintain the baseline antiretroviral regimen (the control group). The study has been registered with ClinicalTrials.gov under the identifier NCT00323492. RESULTS: Ninety-one patients were included in the intent-to-treat (ITT) analysis with triglycerides 2.4 mmol/L and LDL-cholesterol 4.0 mmol/L (median values). At week 12, the median changes from baseline of triglycerides were -0.5 mmol/L (-25%; n = 46) and -0.1 mmol/L (-6%; n = 45) in the tenofovir disoproxil fumarate + emtricitabine and control groups, respectively, indicating a difference of -0.4 mmol/L (P = 0.034) [95% confidence interval (CI): -0.9 to -0.0]. Similarly for LDL-cholesterol, changes of -0.4 mmol/L (-9%) and -0.1 mmol/L (-1%) were observed in the tenofovir disoproxil fumarate + emtricitabine and control groups, respectively, indicating a difference of -0.4 mmol/L (P = 0.031) [95% CI: -0.7 to -0.0]. The proportion of patients with LDL-cholesterol >4.1 mmol/L decreased from 48% at baseline to 26% at week 12 in the tenofovir disoproxil fumarate + emtricitabine group versus no change in the control group. No virological failure was observed during the study. CONCLUSIONS: Switching to tenofovir disoproxil fumarate + emtricitabine in dyslipidaemic HIV-infected patients improves triglycerides and LDL-cholesterol.
Authors:
M A Valantin; R Bittar; P de Truchis; D Bollens; L Slama; P Giral; D Bonnefont-Rousselot; P P?tour; C Aubron-Olivier; D Costagliola; C Katlama;
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-01-06
Journal Detail:
Title:  The Journal of antimicrobial chemotherapy     Volume:  65     ISSN:  1460-2091     ISO Abbreviation:  J. Antimicrob. Chemother.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-10     Completed Date:  2010-04-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7513617     Medline TA:  J Antimicrob Chemother     Country:  England    
Other Details:
Languages:  eng     Pagination:  556-61     Citation Subset:  IM    
Affiliation:
Department of Infectious Diseases, AP-HP, Piti?-Salp?tri?re Hospital, Paris, France. marc-antoine.valantin@psl.ap-hop-paris.fr
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MeSH Terms
Descriptor/Qualifier:
Adenine / adverse effects,  analogs & derivatives*,  therapeutic use
Adult
Anti-HIV Agents / adverse effects,  therapeutic use*
Cholesterol, LDL / blood*
Deoxycytidine / adverse effects,  analogs & derivatives*,  therapeutic use
Female
HIV Infections / drug therapy*
Humans
Male
Middle Aged
Nucleosides / adverse effects,  therapeutic use*
Phosphonic Acids / adverse effects,  therapeutic use*
Triglycerides / blood*
Chemical
Reg. No./Substance:
0/Anti-HIV Agents; 0/Cholesterol, LDL; 0/Nucleosides; 0/Phosphonic Acids; 0/Triglycerides; 0/emtricitabine; 0/tenofovir disoproxil; 73-24-5/Adenine; 951-77-9/Deoxycytidine
Investigator
Investigator/Affiliation:
M Bentata / ; F Rouges / ; F Touam / ; J F Bergmann / ; A Rami / ; M Parrinello / ; Z Ouazene / ; B Lef?bvre / ; O Bouchaud / ; T Huynh / ; O Caubet / ; J L Pellegrin / ; L De Saint Martin / ; V Bellein / ; M L Guenegues / ; J F Delfraissy / ; P Dellamonica / ; J Durant / ; M A Serini / ; C Drobacheff-Thi?baut / ; A Foltzer / ; J A Gastaut / ; E Peyrouse / ; B Hoen / ; A Foltzer / ; V Jeantils / ; S Tassi / ; L Schneider / ; N Bentaleb / ; C Perronne / ; H Berth? / ; G Pialoux / ; C Fontaine / ; L Piroth / ; S Treuvelot / ; T Prazuck / ; L Hocqueloux / ; B De Dieuleveult / ; D Sereni / ; C Pintado / ; J M Ragnaud / ; D Neau / ; I Raymond / ; A Simon / ; C Trepo / ; B Lebouch? / ; C Brochier / ; R Verdon / ; J J Parienti / ; P Feret / ; B Bonnet / ; M Doucet / ; R Ebrahimi / ; A Firek / ; J Gonzalez / ; A Trylesinski / ; F Beauvais / ; V H?rault / ; T Caraes /

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