| Autor: |
Stein, James H., Komarow, Lauren, Cotter, Bruno R., Currier, Judith S., Dubé, Michael P., Fichtenbaum, Carl J., Gerschenson, Mariana, Mitchell, Carol K.C., Murphy, Robert L., Squires, Kathleen, Parker, Robert A., Torriani, Francesca J. |
| Předmět: |
|
| Zdroj: |
Journal of Clinical Lipidology; Dec2008, Vol. 2 Issue 6, p464-471, 8p |
| Abstrakt: |
Background: Dyslipidemia is a frequent complication of antiretroviral therapy (ART) for patients with human immunodeficiency virus infection (HIV). The effects of ART on lipoproteins are less well-understood, and have not been investigated in a prospective study where assignment to ART is randomized. Objective: To evaluate the effects of three class-sparing ART regimens on lipids and lipoproteins. Methods: This was a substudy of a prospective, multicenter study of treatment-naïve HIV-infected individuals randomly assigned to receive a regimen of nucleoside reverse transcriptase inhibitors (NRTIs) + the non-nucleoside reverse transcriptase inhibitor efavirenz, NRTIs + the protease inhibitor lopinavir/ritonavir, or a NRTI-sparing regimen of efavirenz + lopinavir/ritonavir. Lipoproteins were measured by nuclear magnetic resonance spectroscopy. Results: Among the 82 participants, total and small low-density lipoprotein concentrations increased by a median of 152 nmol/L (interquartile range, −49 to +407 nmol/L; P < 0.01) and 130 nmol/L (interquartile range, −98 to +417 nmol/L; P < 0.01), respectively, especially in the arms containing lopinavir/ritonavir (P KW < 0.04). Very-low-density lipoproteins also increased (P < 0.01), with a larger increase in the arms that contained lopinavir/ritonavir (P = 0.022). High-density lipoproteins increased by a median of 6.0 nmol/L (interquartile range, 2.8–10.4 nmol/L; P < 0.01), but differences between arms were not significant (P KW = 0.069). Changes were not related to changes in markers of insulin/glucose metabolism. Conclusions: Total and small low-density lipoprotein concentrations increased, especially in the arms containing lopinavir/ritonavir, as did increases in total very-low-density lipoproteins. Adverse changes were especially prominent in the arm with efavirenz + lopinavir/ritonavir. [Copyright &y& Elsevier] |
| Databáze: |
Supplemental Index |
| Externí odkaz: |
|
Full Text from ScienceDirect